Provider Demographics
NPI:1922122258
Name:LUEPKER, ELLEN THOMPSON (MSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:THOMPSON
Last Name:LUEPKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:821 RAYMOND AVE
Mailing Address - Street 2:STE 440
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1525
Mailing Address - Country:US
Mailing Address - Phone:651-642-9317
Mailing Address - Fax:651-642-1908
Practice Address - Street 1:821 RAYMOND AVE
Practice Address - Street 2:STE 440
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1525
Practice Address - Country:US
Practice Address - Phone:651-642-9317
Practice Address - Fax:651-642-1908
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN037531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical