MEDICARE: SUSAN YANG

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	34612	MN

General Provider Information

NPI Number	:	1538029483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN YANG

Provider Business Mailing Address
First Line	:	3429 53RD AVE N APT 108
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-3440
Country	:	US
Telephone Number	:	763-334-0556
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 78TH AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55445-2758
Country	:	US
Telephone Number	:	651-314-0349
Fax Number	:

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

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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Directions to “ SUSAN YANG ” Practice Location

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