Nancy Marie Cusack, M.A.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 3907 Issued in MN

Practice address

425 Coon Rapids Blvd NW Ste 200
Suite 100
Coon Rapids, MN 55433-2753

Phone

(763) 784-3008

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1639232804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 24TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063023",
            "telephone_number": "612-823-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 COON RAPIDS BLVD NW STE 200",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332753",
            "telephone_number": "763-784-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "NANCY",
        "middle_name": "MARIE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 3907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP 37869",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201945100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James D Cumming, MD
• Kimberly G Cunningham, PA-C
• Lynae Cunningham, RN
• Jennie Curry, MS, LPCC
• Bethany J Curtis, ATC
• Justin Robert Cusick, CRNA
• Robert J Dado, MD
• Adelle Daigle-Bjerke, CRNA
• Megan Dallas
• Joshua Campbell Dames

• Psychologist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.