Provider Demographics
NPI:1780394890
Name:MIDWINTER, ALLISON (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MIDWINTER
Suffix:
Gender:
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:FRANDRUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1900 SILVER LAKE RD NW
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1786
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:11010 PRAIRIE LAKES DR STE 350
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3801
Practice Address - Country:US
Practice Address - Phone:952-746-2522
Practice Address - Fax:952-746-0887
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN275341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical