Provider Demographics
NPI:1225914203
Name:NNENANYA, CELESTINE C
Entity type:Individual
Prefix:
First Name:CELESTINE
Middle Name:C
Last Name:NNENANYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 E SAINT GERMAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56304-4561
Mailing Address - Country:US
Mailing Address - Phone:320-237-7033
Mailing Address - Fax:
Practice Address - Street 1:1560 E SAINT GERMAIN ST APT 1991560E
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56304-4561
Practice Address - Country:US
Practice Address - Phone:320-237-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN351731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical