Suzanne Claire Tuttle, LICSW
Individual provider Active NPI Clinical Social Worker · Ham Lake, MN
NPI 1457088635 · NPPES record last updated Aug 6, 2022
Key facts
- NPI
- 1457088635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 11132 (MN)
- Practice address
- 4326 176TH Ave. N.E.
Ham Lake, MN 55304 - Phone
- (612) 644-5326
- NPI assigned
- Aug 6, 2022
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11132 | MN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11132 | MN | Yes |
Addresses
Primary practice location
4326 176TH Ave. N.E.
Ham Lake, MN 55304
Mailing address
4326 176TH Ave. N.E.
Ham Lake, MN 55304
Phone (612) 644-5326
Other providers in Ham Lake, MN
- Diana Rose Symens
- Julie Anne Tarro
- Imaim Neng Thao
- Mitchell Timothy Thilges
- Kiaja Tolzmann
- Cathy Linn Wagamon
- Jeffrey Paul Wendt
- Willow Tree Psychotherapy LLC
- Ken Wilson
- Sarah Ann Zamora
All providers in Ham Lake, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.