Healthcare Provider Details

I. General information

NPI: 1902436769
Provider Name (Legal Business Name): REUSS THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4154 SHORELINE DR STE 240
SPRING PARK MN
55384-5608
US

IV. Provider business mailing address

4154 SHORELINE DR STE 240
SPRING PARK MN
55384-5608
US

V. Phone/Fax

Practice location:
  • Phone: 952-392-9457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MELANIE REUSS
Title or Position: OWNER
Credential: LMFT, LPCC
Phone: 952-836-5081