Provider Demographics
NPI:1295737716
Name:AHRENS, PATRICIA MULLIN (LICSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MULLIN
Last Name:AHRENS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:KAY
Other - Last Name:PARSINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:540 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1601
Mailing Address - Country:US
Mailing Address - Phone:952-442-4437
Mailing Address - Fax:952-442-3084
Practice Address - Street 1:540 E 1ST ST
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1601
Practice Address - Country:US
Practice Address - Phone:952-442-4437
Practice Address - Fax:952-442-3084
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN513104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN22F12AHOtherBLUECROSSBLUESHIELD
MNHP30775OtherHEALTH PARTNERS
MN172038OtherU-CARE
MN6243814OtherUBH-MEDICA
MN1017800OtherPREFERRED ONE