Provider Demographics
NPI:1316705056
Name:PRIVRATSKY, NATASHA MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIE
Last Name:PRIVRATSKY
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 1:4389 ARDEN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1946
Mailing Address - Country:US
Mailing Address - Phone:612-418-7973
Mailing Address - Fax:
Practice Address - Street 1:23 9TH AVE S
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-7629
Practice Address - Country:US
Practice Address - Phone:952-938-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN202921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical