MEDICARE: ELIZABETH SAMUEL 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	29063	MN
2	1041C0700X	Clinical Social Worker	11880-123	WI

General Provider Information

NPI Number	:	1164281713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH SAMUEL LICSW

Provider Business Mailing Address
First Line	:	6442 CITY WEST PKWY STE 200
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6442 CITY WEST PKWY STE 200
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-2809
Country	:	US
Telephone Number	:	763-318-2788
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	08/14/2024

Similar Medicare Providers

1013420561 — ROGERS MEMORIAL HOSPITAL INCORPORATED
Practice Location Address:

6442 CITY WEST PKWY STE 200
EDEN PRAIRIE, MN
55344-2809

Practice Phone: 800-767-4411
Practice Fax:

1215606124 — ANGELA M SHENGENA CNP
Practice Location Address:

6442 CITY WEST PKWY STE 200
EDEN PRAIRIE, MN
55344-2809

Practice Phone: 763-318-2800
Practice Fax: 763-318-2801

1245993120 — DR. DANIEL ELCHERT PHD
Practice Location Address:

6442 CITY WEST PKWY STE 200
EDEN PRAIRIE, MN
55344-2809

Practice Phone: 763-318-2800
Practice Fax:

1184766859 — GOOD HANDS CARE HOME HEALTH SERVICES, INC
Practice Location Address:

2809 TANNER WAY
GRAND PRAIRIE, TX
75052-4239

Practice Phone: 469-767-6306
Practice Fax: 972-641-7556

1003968900 — KRISTINE LYNN FELSMAN FREILING PA-C
Practice Location Address:

11995 SINGLETREE LN STE 325
EDEN PRAIRIE, MN
55344-5349

Practice Phone: 651-968-5201
Practice Fax: 651-968-5903

1659946028 — WORKIT HEALTH MI PLLC
Practice Location Address:

11800 SINGLETREE LN STE 303
EDEN PRAIRIE, MN
55344-5398

Practice Phone: 651-349-4342
Practice Fax:

Directions to “ ELIZABETH SAMUEL LICSW” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.