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Individual

ELAINE VIVIAN HUSELID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED

Contact information

Practice address
14579 GRAND AVE, SUITE 200, BURNSVILLE, MN 55306-5702
(952) 797-3169
(952) 426-1725
Mailing address
1641 W 140TH ST, BURNSVILLE, MN 55337-4418
(952) 797-3169
(952) 426-1725

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
3047
MN
1041C0700X
Clinical Social Worker
Primary
6542
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01020012
BHP PROVIDER #
MN
01
14D35HU AND 14D36HU
BCBS PROVIDER #
MN
01
62-37268
UBH PROVIDER #
MN
01
HP 28356
HEALTH PARTNER'S PROVIDER
MN
Enumeration date
12/18/2006
Last updated
09/11/2025
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