Provider Demographics
NPI:1073590279
Name:MARRS, LYNN MARIE (MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:MARRS
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6347 UPLAND LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-4005
Mailing Address - Country:US
Mailing Address - Phone:612-202-9085
Mailing Address - Fax:763-422-8283
Practice Address - Street 1:6347 UPLAND LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-4005
Practice Address - Country:US
Practice Address - Phone:612-202-9085
Practice Address - Fax:763-422-8283
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN109211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN115D3MAOtherBCBS OF MN
MN215536200Medicaid
MN1020748OtherPREFERRED ONE
MN152250OtherU-CARE
MN356S5MAOtherBLUE CROSS BLUE SHIELD
MN62-01251OtherUBH (MEDICA)
MNHP24441OtherHEALTH PARTNERS
MN6278216OtherUNITED BEHAVIORAL HEALTH
MN62-01251OtherUBH (MEDICA)