Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jean Louise Fagerstrom, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1861963118

Jean Louise Fagerstrom, MSW, LICSW is a Clinical Social Worker in Roseville, Minnesota. Graduated from University of Minnesota Medical School in 2004, 22 years ago. Practices with Nathan and Associates LLC, a 4-clinician group and offers telehealth.

Years since qualifying
22
Trained at
University of Minnesota Medical School
In the registry since
2018
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2233 Hamline Ave N Ste 435
Roseville, MN 55113-5023
Phone: (612) 440-8535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1861963118
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorYes
NPI enumeratedDecember 16, 2018
Last updated in NPPESDecember 16, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2004 (22 years in practice)
Group practice Nathan And Associates Llc — 4 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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