NANCY MARIE CUSACK


Address: 425 Coon Rapids Blvd Nw Ste 200, Suite 100, Coon Rapids, MN 55433-2753
Phone: 7637843008

NANCY MARIE CUSACK (NPI# 1639232804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639232804
Entity Type Individual
Full Name NANCY MARIE CUSACK
Credential M.A.
Practice Address 425 Coon Rapids Blvd Nw Ste 200
Suite 100
Coon Rapids
MN 55433-2753
Mailing Address 4023 24th Ave S
Minneapolis
MN 55406-3023
Practice Telephone 7637843008
Mailing Telephone 6128236578
Enumeration Date 2006-12-19
Last Update Date 2011-12-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist LP 3907 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN HEALTH PARTNERS HP 37869 01
MN 201945100 05

Other Providers NANCY CUSACK

NPI Name Taxonomy Address Enumeration
1689943664 Nancy Cusack Registered Nurse 50 Blauvelt Rd, Nanuet, NY 10954-3445 2011-12-21

Office Location

Street Address 425 COON RAPIDS BLVD NW STE 200
SUITE 100
City COON RAPIDS
State MN
Zip Code 55433-2753

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861861312 Teresa Morris Marriage & Family Therapist 425 Coon Rapids Blvd Nw Ste 200, Coon Rapids, MN 55433-2753 2015-09-15
1790105880 Jody Mork Marriage & Family Therapist 425 Coon Rapids Blvd Nw Ste 200, Coon Rapids, MN 55433-2753 2014-04-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770134793 Shelley Karee Peterson Technician 10311 Bittersweet St Nw, Coon Rapids, MN 55433 2019-09-20
1578122057 Courtney Gau Behavior Technician Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 2019-06-10
1992275606 Maliki Fofee Kamara Licensed Practical Nurse 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 2018-11-26
1992284541 Sarah Vennes Massage Therapist 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 2018-08-13
1538646609 Paige Prince Behavior Technician Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 2018-07-23
1154828242 Karin Lea Englund Dentist 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 2018-04-06
1235642513 Vista Family Eye Care LLC Optometrist 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 2017-11-09
1538697818 Mohammed Nmn Ahmed Internal Medicine 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 2017-05-31
1639531353 Journi LLC Nurse Practitioner 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 2016-03-22
1821457722 Honorine Boyce Licensed Practical Nurse 2743 111th Ave. Nw, Coon Rapids, MN 55433 2016-02-19
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710053301 Michael Hitzelberger Psychologist 425 Coon Rapids Blvd #200, Nscc, Coon Rapids, MN 58433 2006-11-27
1518033109 Julie L Weekley Psychologist 425 Coon Rapids Blvd # 200, Nscc, Coon Rapids, MN 55433 2006-11-27
1225102973 Linda Jean Hawkins Psychologist 551 Coon Rapids Blvd, 150, Coon Rapids, MN 55433-5520 2006-11-17
1871674978 Robert Cornell Van Siclen Psychologist 277 Coon Rapids Blvd Nw, Suite 308, Coon Rapids, MN 55433-5843 2006-10-17
1093777591 Catherine Jane Luitjens Psychologist 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433 2006-04-03
1477537678 Luann Lengas Heim Psychologist 1930 Coon Rapids Boulevard, Family Life Mental Health Center, Coon Rapids, MN 55433 2005-12-01
1093230088 Jarett Edward Roseberry Psychologist 11850 Blackfoot St Nw Ste 400, Coon Rapids, MN 55433-2776 2017-08-10
1225379381 Linda Rae Deters Psychologist 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 2013-03-13
1023361292 Rand Ollen Adams Psychologist 1930 Coon Rapids Blvd Nw, Family Life Mental Health, Coon Rapids, MN 55433-4708 2012-10-24
1962687624 Andrea Loveless Psychologist 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 2007-12-31
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Competitor

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City COON RAPIDS
Zip Code 55433

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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