Provider Demographics
NPI:1669799201
Name:EASTER, NANCY M (LICSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:M
Last Name:EASTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:2025 E RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3604
Mailing Address - Country:US
Mailing Address - Phone:612-596-6100
Mailing Address - Fax:
Practice Address - Street 1:2025 E RIVER PKWY
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3604
Practice Address - Country:US
Practice Address - Phone:612-596-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN199381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical