Provider Demographics
NPI:1093582413
Name:KAPUSTKA, LUCY
Entity Type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:
Last Name:KAPUSTKA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LUCY
Other - Middle Name:
Other - Last Name:KASTONEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3260 78TH ST E
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-3032
Mailing Address - Country:US
Mailing Address - Phone:414-712-3765
Mailing Address - Fax:
Practice Address - Street 1:3333 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3325
Practice Address - Country:US
Practice Address - Phone:612-767-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical