Provider Demographics
NPI:1578399523
Name:DOHM, ABIGAIL (LICSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:DOHM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:ISLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:333 WASHINGTON AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1352
Mailing Address - Country:US
Mailing Address - Phone:612-315-0011
Mailing Address - Fax:
Practice Address - Street 1:333 WASHINGTON AVE N STE 200
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-1352
Practice Address - Country:US
Practice Address - Phone:612-315-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN312511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical