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NPI Code Detail

MEDICARE: CRYSTAL WIMPFHEIMER LICSW

MEDICARE: CRYSTAL WIMPFHEIMER 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
11041C0700XClinical Social Worker21445MN

General Provider Information

NPI Number : 1962386284
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL WIMPFHEIMER LICSW
Provider Business Mailing Address
First Line : 13182 RANCH RD NW
Second Line :
City : ELK RIVER
State : MN
Zip : 55330-8709
Country : US
Telephone Number : 763-291-7260
Fax Number :
Provider Business Practice Location Address
First Line : 400 JACKSON AVE NW
Second Line :
City : ELK RIVER
State : MN
Zip : 55330-3926
Country : US
Telephone Number : 763-308-5081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2025
Last Update Date : 07/31/2025

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Directions to “ CRYSTAL WIMPFHEIMER LICSW” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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