Provider Demographics
NPI:1558097303
Name:DUELLMAN, NATASHA LYNN (MSW, LGSW-PL, LADC)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:LYNN
Last Name:DUELLMAN
Suffix:
Gender:F
Credentials:MSW, LGSW-PL, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4620
Mailing Address - Country:US
Mailing Address - Phone:075-361-3001
Mailing Address - Fax:
Practice Address - Street 1:25 16TH ST NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-4620
Practice Address - Country:US
Practice Address - Phone:507-361-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306419101YA0400X
MN339581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)