Provider Demographics
NPI:1609674324
Name:MOEWS, EMILY ADELE (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ADELE
Last Name:MOEWS
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 1:790 CLEVELAND AVE S STE 211
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3845
Mailing Address - Country:US
Mailing Address - Phone:612-428-2409
Mailing Address - Fax:
Practice Address - Street 1:790 CLEVELAND AVE S STE 211
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3845
Practice Address - Country:US
Practice Address - Phone:612-428-2409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4934511041S0200X
MN252211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool