Basic Information
| Provider Information | |||||||||
| NPI: | 1093351363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILBERTSON | ||||||||
| FirstName: | DANIELLE | ||||||||
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| Credential: | MSW, LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554400043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122621166 | ||||||||
| FaxNumber: | 6122624258 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 HIGHWAY 65 S | ||||||||
| Address2: | |||||||||
| City: | MORA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550511899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202253577 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2019 | ||||||||
| LastUpdateDate: | 09/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 19691 | MN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.