Provider Demographics
NPI:1598550634
Name:TUETKEN, TESSA (LICSW)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:TUETKEN
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 EXCELSIOR BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4960
Mailing Address - Country:US
Mailing Address - Phone:612-666-1533
Mailing Address - Fax:
Practice Address - Street 1:4601 EXCELSIOR BLVD STE 501
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-4960
Practice Address - Country:US
Practice Address - Phone:612-666-1533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN284201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical