Provider Demographics
NPI:1538358627
Name:HONTOS, PATRICIA THIENES (LICSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:THIENES
Last Name:HONTOS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 4TH AVE
Mailing Address - Street 2:BUILDING 9
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1161
Mailing Address - Country:US
Mailing Address - Phone:763-433-3197
Mailing Address - Fax:
Practice Address - Street 1:3300 4TH AVE
Practice Address - Street 2:BUILDING 9
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-1161
Practice Address - Country:US
Practice Address - Phone:763-433-3197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN75641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical