1710367958 NPI number — MS. SHERI LYNN JUDGE ARNETT MSW/LICSW

Table of content: MS. SHERI LYNN JUDGE ARNETT MSW/LICSW (NPI 1710367958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710367958 NPI number — MS. SHERI LYNN JUDGE ARNETT MSW/LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARNETT
Provider First Name:
SHERI
Provider Middle Name:
LYNN JUDGE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW/LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JACOBS
Provider Other First Name:
SHERI
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710367958
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
640 JACKSON ST.
Provider Second Line Business Mailing Address:
ED CRISIS UNIT - MAIL STOP: 11302B
Provider Business Mailing Address City Name:
ST. PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55101-2595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-254-1000
Provider Business Mailing Address Fax Number:
651-254-9595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
640 JACKSON ST.
Provider Second Line Business Practice Location Address:
ED CRISIS UNIT - MAIL STOP 11302B
Provider Business Practice Location Address City Name:
ST. PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55101-2595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-254-1000
Provider Business Practice Location Address Fax Number:
651-254-9595
Provider Enumeration Date:
06/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03236 . This is a "MSW/LICSW" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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