MEDICARE: ERIN BRANDEL DYKHUIZEN 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	19717	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19717	OTHER	MN	BOARD OF SOCIAL WORK LICENSE

General Provider Information

NPI Number	:	1538434410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN BRANDEL DYKHUIZEN LICSW

Provider Business Mailing Address
First Line	:	1163 BROOKS AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55113-3202
Country	:	US
Telephone Number	:	612-722-2713
Fax Number	:

Provider Business Practice Location Address
First Line	:	2233 UNIVERSITY AVE W STE 420
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55114-1629
Country	:	US
Telephone Number	:	651-998-8991
Fax Number	:

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

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	06/21/2025

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