Molly Marie Bartusch, MA

Individual provider Active NPI Marriage & Family Therapist · Minneapolis, MN

NPI 1124374152 · NPPES record last updated Jan 14, 2015

Key facts

NPI
1124374152
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
000356 (IA)
Practice address
525 Portland Ave South
Minneapolis, MN 55415-1569
Phone
(612) 596-7898
Fax
(612) 677-6357
NPI assigned
Jul 27, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000356IAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000356 IA Yes

Addresses

Primary practice location

525 Portland Ave South
Minneapolis, MN 55415-1569

Mailing address

525 Portland Ave South
Minneapolis, MN 55415-1569
Phone (612) 596-7898

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · Marriage & Family Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.