Lucas Michael Elsner

Individual provider Active NPI Behavior Technician · Hermantown, MN

NPI 1689463572 · NPPES record last updated May 6, 2025

Key facts

NPI
1689463572
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
5155 Miller Trunk Hwy
Hermantown, MN 55811-1203
Phone
(952) 767-4200
Fax
(952) 767-4211
NPI assigned
May 6, 2025
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

5155 Miller Trunk Hwy
Hermantown, MN 55811-1203

Mailing address

5860 Baker Rd
Minnetonka, MN 55345-5903
Phone (952) 767-4200

Other providers in Hermantown, MN

All providers in Hermantown, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.