Provider Demographics
NPI:1568448728
Name:LUSKIN, BARBARA (PHD, LP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LUSKIN
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 WYCLIFF ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1279
Mailing Address - Country:US
Mailing Address - Phone:651-647-1083
Mailing Address - Fax:651-642-1230
Practice Address - Street 1:2380 WYCLIFF ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1279
Practice Address - Country:US
Practice Address - Phone:651-647-1083
Practice Address - Fax:651-642-1230
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4329103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN323J7LUOtherBLUE CROSS BLUE SHIELD
MN497448400Medicaid
MN2163333OtherCIGNA
MN113185OtherUCARE