Shannon Jeanette Acuna, LICSW

Individual provider Active NPI Clinical Social Worker · St Louis Park, MN

NPI 1770100919 · NPPES record last updated Nov 26, 2024

Key facts

NPI
1770100919
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
18778 (MN)
Practice address
5891 Cedar Lake Rd S # 205
St Louis Park, MN 55416-1460
Phone
(763) 438-5424
NPI assigned
Jul 4, 2020
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)
Yes

State licenses

LicenseStateTypeSpecialty
18778MNMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18778 MN Yes

Addresses

Primary practice location

5891 Cedar Lake Rd S # 205
St Louis Park, MN 55416-1460

Mailing address

10244 Quaker Lane N
Maple Grove, MN 55369

Other providers in St Louis Park, MN

All providers in St Louis Park, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.