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Search › Minnesota › 1041C0700X

Tyler Russell, LICSW

NPI 1033055991 · on the registry since 2026

Practice

Address
9220 Bass Lake Rd Ste 255
New Hope, MN 55428
Phone
(763) 225-4052
Organisation at this address
Your Dental
Life Clinic Pllc
Fairview Express Care
Amalfi Health Care Llc
Delight Transportation Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
52

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
MN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-04-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota