Provider Demographics
NPI:1720341811
Name:KRUSINSKY, MICHAEL PAUL (LCSW, BCD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:KRUSINSKY
Suffix:
Gender:
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7221
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55903-7221
Mailing Address - Country:US
Mailing Address - Phone:504-517-5864
Mailing Address - Fax:312-586-8148
Practice Address - Street 1:PO BOX 7221
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55903-7221
Practice Address - Country:US
Practice Address - Phone:504-517-5864
Practice Address - Fax:312-586-8148
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490169821041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical