Elizabeth Ruskin Shanklin, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11123 Issued in MN

Practice address

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708

Phone

(763) 427-7964

Fax

(763) 427-7976

NPI assigned

Sep 20, 2006

Last updated

Dec 10, 2008By the provider in NPPES

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 6

Other names 1

• Elizabeth Ruskin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Family Life Mental Health Center

  • Clinical Social Worker
  • Coon Rapids, MN
  • NPI 1760489751
  NPD (past)
• Kenwood Therapy Center, LLC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1144271230
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1841398260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334708",
            "telephone_number": "763-427-7964",
            "fax_number": "763-427-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334708",
            "telephone_number": "763-427-7964",
            "fax_number": "763-427-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKLIN",
        "first_name": "ELIZABETH",
        "middle_name": "RUSKIN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "11123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1013871",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6270885",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP70711",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "584G2SH",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052318600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "119993",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "RUSKIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Sewalson, PHARMD
• Marjorie Jean Sexton, MD
• Alexis Shaffer
• Nicole M Shaffer
• Sadichhya Shakya
• Shanna C Miller, DC PLLC
• Claire Shape
• Gabriel Shapiro, LADC
• Alia Sharif, M.D.
• Saada Oumer Shato

• Social Worker in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.