Provider Demographics
NPI:1194875856
Name:SHANALINGIGWA, OSWALD ABEL (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:OSWALD
Middle Name:ABEL
Last Name:SHANALINGIGWA
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:5091 RAINBOW LN
Mailing Address - Street 2:
Mailing Address - City:MOUNDS VIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55112-4853
Mailing Address - Country:US
Mailing Address - Phone:763-717-7356
Mailing Address - Fax:651-291-7378
Practice Address - Street 1:400 SIBLEY ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1941
Practice Address - Country:US
Practice Address - Phone:651-291-1979
Practice Address - Fax:651-291-7378
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN155751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical