MEDICARE: MRS. MELISSA ANNE RAATZ MSW, LICSW, CHT

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	3462	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942778022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA ANNE RAATZ MSW, LICSW, CHT

Provider Business Mailing Address
First Line	:	417 RUCKS FARM RD
Second Line	:
City	:	DELANO
State	:	MN
Zip	:	55328-8837
Country	:	US
Telephone Number	:	763-242-3261
Fax Number	:	866-318-3073

Provider Business Practice Location Address
First Line	:	10505 WAYZATA BLVD STE 203-3
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55305-1502
Country	:	US
Telephone Number	:	763-242-3261
Fax Number	:	866-318-3073

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

Provider Enumeration Date	:	11/07/2018
Last Update Date	:	06/10/2026

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