Provider Demographics
NPI:1053997973
Name:AUEN, JENNA (LICSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:AUEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 1ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:CLARKS GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:56016-7741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:CLARKS GROVE
Practice Address - State:MN
Practice Address - Zip Code:56016-7741
Practice Address - Country:US
Practice Address - Phone:507-383-5394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN189891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical