Provider Demographics
NPI:1831909175
Name:HEMMESCH, SUSAN JANE
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANE
Last Name:HEMMESCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 48TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6517
Mailing Address - Country:US
Mailing Address - Phone:507-923-3726
Mailing Address - Fax:
Practice Address - Street 1:3535 40TH AVE NW STE 210
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1769
Practice Address - Country:US
Practice Address - Phone:507-516-0227
Practice Address - Fax:507-516-0228
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN336261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical