Provider Demographics
NPI:1003943168
Name:DUNHAUPT, SUSAN FRANCES (LICSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:FRANCES
Last Name:DUNHAUPT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2024
Mailing Address - Country:US
Mailing Address - Phone:612-702-0161
Mailing Address - Fax:
Practice Address - Street 1:300 3RD AVE SE
Practice Address - Street 2:SUITE 405
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4619
Practice Address - Country:US
Practice Address - Phone:507-288-8544
Practice Address - Fax:507-288-8545
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN245J5DUOtherBCBS OF MN
MN62-75557OtherUNITED BEHAVIORAL HEALTH
MN921001031398OtherPREFERRED ONE
MNHP21135OtherHEALTHPARTNERS