Basic Information
| Provider Information | |||||||||
| NPI: | 1053811901 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SLETTEN | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LICSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SOLBERG | ||||||||
| OtherFirstName: | ERIKA | ||||||||
| OtherMiddleName: | ANNE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1217 8TH ST N | ||||||||
| Address2: | |||||||||
| City: | NEW ULM | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560731552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072175000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1217 8TH ST N | ||||||||
| Address2: | |||||||||
| City: | NEW ULM | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560731552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072175000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2018 | ||||||||
| LastUpdateDate: | 04/23/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 15715 | MN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.