Provider Demographics
NPI:1427145564
Name:SEARCH, JAN (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:SEARCH
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304A MOUNT VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-1960
Mailing Address - Country:US
Mailing Address - Phone:612-849-5059
Mailing Address - Fax:612-465-1580
Practice Address - Street 1:2304A MOUNT VIEW AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-1960
Practice Address - Country:US
Practice Address - Phone:612-849-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7696210OtherMINNESOTA TAX ID
MN202561815OtherFEDERAL TAX ID
MN7G348SEOtherBCBS PAYEE ID