Basic Information
Provider Information
NPI: 1669608014
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GINSBERG
FirstName: JANE
MiddleName: RITA
NamePrefix:  
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 414 S 8TH ST
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554041025
CountryCode: US
TelephoneNumber: 6123399101
FaxNumber: 6123411642
Practice Location
Address1: 414 S 8TH ST
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554041025
CountryCode: US
TelephoneNumber: 6123399101
FaxNumber: 6123411642
Other Information
ProviderEnumerationDate: 05/29/2009
LastUpdateDate: 05/29/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X19604MNY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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