Provider Demographics
NPI:1952358004
Name:TOUTGES, CHERYL L (LICSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:TOUTGES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1138 20TH ST N
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-1843
Mailing Address - Country:US
Mailing Address - Phone:218-233-7524
Mailing Address - Fax:219-233-8627
Practice Address - Street 1:1010 32ND AVE S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5001
Practice Address - Country:US
Practice Address - Phone:218-233-7524
Practice Address - Fax:218-233-8627
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN170461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN62-51361OtherUNITED BEHAVIORAL HEALTH
MN663T6TOOtherBLUE SHIELD OF MINNESOTA
ND26055OtherNORTH DAKOTA BLUE SHIELD
MN137061OtherUCARE MINNESOTA
MNHP56455OtherHEALTHPARTNERS
MN1044855OtherPREFERREDONE