Healthcare Provider Details

I. General information

NPI: 1538434410
Provider Name (Legal Business Name): ERIN BRANDEL DYKHUIZEN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 UNIVERSITY AVE W STE 420
SAINT PAUL MN
55114-1629
US

IV. Provider business mailing address

1163 BROOKS AVE W
SAINT PAUL MN
55113-3202
US

V. Phone/Fax

Practice location:
  • Phone: 651-998-8991
  • Fax:
Mailing address:
  • Phone: 612-722-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19717
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: