Provider Demographics
NPI:1689077935
Name:HAUGEN, CHERISE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:CHERISE
Middle Name:
Last Name:HAUGEN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:CHERISE
Other - Middle Name:
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1875 STATION PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-3319
Mailing Address - Country:US
Mailing Address - Phone:763-482-9598
Mailing Address - Fax:612-235-6447
Practice Address - Street 1:11090 183RD CIR NW STE A
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-2884
Practice Address - Country:US
Practice Address - Phone:763-482-9598
Practice Address - Fax:612-235-6447
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN206451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical