Individual provider · Type 1 NPI

Patricia Anne Thacker, L.I.C.S.W.

Clinical Social Worker · Minneapolis, MN

NPI number 1720150030 Active

Practice location

2450 Riverside Ave, Suite F196
Minneapolis, MN 55454-1450

Call (612) 672-6999 Map

Mailing address

15370 Yakima St NW
Ramsey, MN 55303-4227

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X17199 (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 1720150030

Patricia Anne Thacker, L.I.C.S.W.'s National Provider Identifier is 1720150030, issued on Nov 14, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Minneapolis, MN. The record was last updated on Jul 9, 2007.