Provider Demographics
NPI:1700915246
Name:NORDLUND, ANN LOUISE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:LOUISE
Last Name:NORDLUND
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 FILBERT LN NE
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-7019
Mailing Address - Country:US
Mailing Address - Phone:218-751-4182
Mailing Address - Fax:
Practice Address - Street 1:5910 LITTLE SAND LN NE
Practice Address - Street 2:
Practice Address - City:REMER
Practice Address - State:MN
Practice Address - Zip Code:56672-4423
Practice Address - Country:US
Practice Address - Phone:218-566-2342
Practice Address - Fax:218-566-2341
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health