Provider Demographics
NPI:1306647227
Name:FESSER, SOPHIA (LGSW, MSW)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:FESSER
Suffix:
Gender:F
Credentials:LGSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4213
Mailing Address - Country:US
Mailing Address - Phone:651-270-5272
Mailing Address - Fax:
Practice Address - Street 1:401 GROVELAND AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3219
Practice Address - Country:US
Practice Address - Phone:651-419-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33461104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker