Provider Demographics
NPI:1992599898
Name:LEUTGEB, CHELSEA RAE GRAN (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RAE GRAN
Last Name:LEUTGEB
Suffix:
Gender:
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 MAPLE BEND DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-5032
Mailing Address - Country:US
Mailing Address - Phone:218-391-2516
Mailing Address - Fax:
Practice Address - Street 1:4135 RICHARD AVE STE 201
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-2979
Practice Address - Country:US
Practice Address - Phone:218-464-0908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN335361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical