Craig Polsfuss, MA, LP, MSW

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0620 Issued in MN

Practice address

15552 Dynasty Way
Apple Valley, MN 55124-7836

Phone

(612) 730-4843

Fax

(651) 344-8298

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Heartland Health LLC

  • Community/Behavioral Health Agency
  • Edina, MN
  • NPI 1043465321
  NPD (past) Authorized official

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811993553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15552 DYNASTY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "55124",
            "telephone_number": "612-730-4843",
            "fax_number": "651-344-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15552 DYNASTY WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247836",
            "telephone_number": "612-730-4843",
            "fax_number": "651-344-8298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6950 France Ave S",
            "address_2": "Ste 14",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352016",
            "country_code": "US",
            "telephone_number": "952-322-2111",
            "fax_number": "952-423-5281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLSFUSS",
        "first_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "MA, LP, MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013848700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pindrop Hearing of Southern Minnesota
• Planned Parenthood Minnesota, North Dakota, South Dakota (PLAN Express Clinic)
• Bethany Rae Plutowski
• Ana Dean Podratz, MSW, LGSW
• Nunu Poe
• Evyn Mae Polsfuss
• Brandi Portero, MD
• Power of Progress Services, LLC (Pops, LLC)
• Powers Psychotherapy, LLC (J Powers Therapy)
• Amanda Bernedette Powers, PSYD LP

• Psychologist in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.