MEDICARE: MS. LYNN MARIE MARRS MSW LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	10921	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	115D3MA	OTHER	MN	BCBS OF MN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1020748	OTHER	MN	PREFERRED ONE
4	152250	OTHER	MN	U-CARE
5	356S5MA	OTHER	MN	BLUE CROSS BLUE SHIELD
6	62-01251	OTHER	MN	UBH (MEDICA)
7	HP24441	OTHER	MN	HEALTH PARTNERS
8	6278216	OTHER	MN	UNITED BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1073590279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNN MARIE MARRS MSW LICSW

Provider Business Mailing Address
First Line	:	6347 UPLAND LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-4005
Country	:	US
Telephone Number	:	612-202-9085
Fax Number	:	763-422-8283

Provider Business Practice Location Address
First Line	:	6347 UPLAND LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-4005
Country	:	US
Telephone Number	:	612-202-9085
Fax Number	:	763-422-8283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	06/05/2024

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