Provider Demographics
NPI:1831521806
Name:JAMISON, EMILY MANN (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MANN
Last Name:JAMISON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 VENUS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-2851
Mailing Address - Country:US
Mailing Address - Phone:704-502-8071
Mailing Address - Fax:
Practice Address - Street 1:3101 OLD HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1072
Practice Address - Country:US
Practice Address - Phone:612-352-9559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0081671041C0700X
MN308851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical