Provider Demographics
NPI:1902530652
Name:PASSOW, JANNEU ANNA (LICSW)
Entity type:Individual
Prefix:
First Name:JANNEU
Middle Name:ANNA
Last Name:PASSOW
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 3RD AVE SE STE 302
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4681
Mailing Address - Country:US
Mailing Address - Phone:507-990-1567
Mailing Address - Fax:
Practice Address - Street 1:300 3RD AVE SE STE 302
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4681
Practice Address - Country:US
Practice Address - Phone:507-990-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN311961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty