Provider Demographics
NPI:1487299491
Name:KAPUSKA, ELAINA E (MA, LPCC)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:E
Last Name:KAPUSKA
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:ELAINA
Other - Middle Name:E
Other - Last Name:HAMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2112 BROADWAY ST. NE
Mailing Address - Street 2:STE 225, PMB 341
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1032 GRAND AVE # 100
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3064
Practice Address - Country:US
Practice Address - Phone:612-509-8629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MN4046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health