Individual provider · Type 1 NPI

Gina Marie Theisz, LICSW

Clinical Social Worker · Buffalo, MN

NPI number 1407158496 Active

Practice location

308 12th Ave S
Buffalo, MN 55313-2321

Call (763) 682-4400 Map

Fax (763) 682-1353

Mailing address

1321 13th St N
St. Cloud, MN 56303-2613

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X18283 (MN)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1407158496

Gina Marie Theisz, LICSW's National Provider Identifier is 1407158496, issued on Nov 23, 2010. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Buffalo, MN. The record was last updated on Aug 30, 2011.