Susan M Kundel, MSW, LICSW
Individual provider Active NPI Social Worker · Saint Paul, MN
NPI 1700908951 · NPPES record last updated Sep 23, 2011
Key facts
- NPI
- 1700908951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 4451 (MN)
- Practice address
- 366 Prior Ave N Ste 202
Saint Paul, MN 55104-5165 - Phone
- (651) 788-2913
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101118000855 | MN | Practitioner - Clinical Social Worker | 5799971578 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4451 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minerva Center for Psychology PLLC | Current |
Accepting new patients | |
| Oak Haven Counseling and Wellness LLC | Past |
Accepting new patients |
Locations
11185 Lake Blvd
Ste 205
Chisago City, MN 55013
Phone (218) 368-1187
7201 Metro Blvd
Ste 550
Minneapolis, MN 55439
Phone (612) 208-6807
2356 University Ave W
Ste 401B
Saint Paul, MN 55114
Phone (858) 769-3719
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 4451 | MN | Yes |
Addresses
Primary practice location
366 Prior Ave N Ste 202
Saint Paul, MN 55104-5165
Mailing address
366 Prior Ave N Ste 202
Saint Paul, MN 55104-5165
Phone (651) 788-2913
Other providers in Saint Paul, MN
- Mukesh Kumar
- Peter Kumasaka
- Andrew Emil Kummer
- Jean Marie Kummer IV
- Rebecca Lynn Kummer
- Mousumi Kundu
- Anne Kunesh-Carney
- Hilary Bauer Kunkel
- Jenna Kunkel
- Ann Kunstleben
All providers in Saint Paul, MN · 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 Sep 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.