Provider Demographics
NPI:1336956291
Name:SELBITSCHKA, EMILY (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SELBITSCHKA
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:KROSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 117TH LN NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-1926
Mailing Address - Country:US
Mailing Address - Phone:651-335-8438
Mailing Address - Fax:
Practice Address - Street 1:1833 3RD AVE
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2424
Practice Address - Country:US
Practice Address - Phone:763-421-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26888104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker