Individual provider · Type 1 NPI

Charlene Marie Hanisch Theisen, MS LICSW

Clinical Social Worker · St. Cloud, MN

NPI number 1437195641 Active

Practice location

850 1st Ave South
St. Cloud, MN 56301-4498

Call (320) 308-3171 Map

Fax (320) 308-0959

Mailing address

720 4th Ave S
St. Cloud, MN 56301-4498

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X12147 (MN)
Clinical Social Worker Primary 1041C0700XNone listed

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 1437195641

Charlene Marie Hanisch Theisen, MS LICSW's National Provider Identifier is 1437195641, issued on Jun 22, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in St. Cloud, MN. The record was last updated on Apr 16, 2025.