Provider Demographics
NPI:1447901160
Name:AHLEMEIER, JESIAH (LICSW, DSW)
Entity type:Individual
Prefix:DR
First Name:JESIAH
Middle Name:
Last Name:AHLEMEIER
Suffix:
Gender:F
Credentials:LICSW, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 ARLINGTON AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-4476
Mailing Address - Country:US
Mailing Address - Phone:424-326-6804
Mailing Address - Fax:
Practice Address - Street 1:164 ARLINGTON AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-4476
Practice Address - Country:US
Practice Address - Phone:424-326-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN266561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical