Provider Demographics
NPI:1205712023
Name:MCDOLE, JESSIE CHRISTINE (MSW, TGLS)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:CHRISTINE
Last Name:MCDOLE
Suffix:
Gender:F
Credentials:MSW, TGLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 CARMEL CT
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-5833
Mailing Address - Country:US
Mailing Address - Phone:612-286-3565
Mailing Address - Fax:
Practice Address - Street 1:4638 VICTOR PATH STE 900
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-4732
Practice Address - Country:US
Practice Address - Phone:651-364-3839
Practice Address - Fax:651-364-3840
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN890481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical