Provider Demographics
NPI:1811017783
Name:KORSCH, ELAINE STRAUSS (LICSW)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:STRAUSS
Last Name:KORSCH
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 1:2164 WATSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1146
Mailing Address - Country:US
Mailing Address - Phone:651-592-7951
Mailing Address - Fax:
Practice Address - Street 1:4660 SLATER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4047
Practice Address - Country:US
Practice Address - Phone:651-592-7951
Practice Address - Fax:651-683-0057
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301120101YA0400X
MN129361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical