Provider Demographics
NPI:1841629250
Name:COLWELL, CHARLENE M (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:M
Last Name:COLWELL
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 1:2932 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-2564
Mailing Address - Country:US
Mailing Address - Phone:218-297-7679
Mailing Address - Fax:218-894-6904
Practice Address - Street 1:2932 1ST AVE
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-2564
Practice Address - Country:US
Practice Address - Phone:218-297-7679
Practice Address - Fax:218-894-6904
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN217121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical