Amy Patrice Kuusisto-lathrop, MSW, LICSW | |
6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, MN 55430-2155 | |
(763) 503-8560 | |
(763) 503-8563 |
Full Name | Amy Patrice Kuusisto-lathrop |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275699381 | NPI | - | NPPES |
29155880 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 10798 (Minnesota) | Primary |
Entity Name | Ramsey County Mental Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235299124 PECOS PAC ID: 5092627000 Enrollment ID: O20040303000748 |
Entity Name | Associated Clinic Of Psychology Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588741292 PECOS PAC ID: 0749171320 Enrollment ID: O20040323000833 |
Mailing Address | Practice Location Address |
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Amy Patrice Kuusisto-lathrop, MSW, LICSW 4240 Park Glen Rd, St Louis Park, MN 55416-5427 Ph: (612) 925-6033 | Amy Patrice Kuusisto-lathrop, MSW, LICSW 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, MN 55430-2155 Ph: (763) 503-8560 |
Melissa Wollman, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6000 Earle Brown Dr, Brooklyn Center, MN 55430 Phone: 952-993-4900 | |
Bobbi Jo B. Krieg, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 5910 Shingle Creek Pkwy, Brooklyn Center, MN 55430 Phone: 763-569-5200 Fax: 763-569-5201 | |
Thomas R. Alf, LICSW, CPRP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5615 Brooklyn Blvd Ste 200, Brooklyn Center, MN 55429 Phone: 763-537-6612 | |
Ms. Skye Davis, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5701 Shingle Creek Pkwy Ste 550, Brooklyn Center, MN 55430 Phone: 763-560-9621 | |
Abigail Lane, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5910 Shingle Creek Pkwy, Brooklyn Center, MN 55430 Phone: 763-569-5200 Fax: 763-569-5201 | |
Ashley Michelle Beltrame, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6040 Earle Brown Dr Ste 420, Brooklyn Center, MN 55430 Phone: 952-522-1814 | |
Michael Elliot Falck, LICSW, CPRP, MA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5615 Brooklyn Blvd Ste 200, Brooklyn Center, MN 55429 Phone: 763-537-6612 Fax: 763-537-7162 |