Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Susan Rose Roeller, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1801193123

MS. Susan Rose Roeller, MSW, LICSW is a Clinical Social Worker in Coon Rapids, Minnesota. Qualified in 2005, 21 years ago. Practices with Lyn-Lake Psychotherapy and Wellness Ltd, a 72-clinician group and offers telehealth. Licensed in Minnesota.

Years since qualifying
21
Licensed in
MN
In the registry since
2011
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone: (763) 427-7964
Fax: (763) 427-7976
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 17878 (MN)

Record details

NPI number1801193123
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedFebruary 23, 2011
Last updated in NPPESFebruary 23, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Lyn-Lake Psychotherapy And Wellness Ltd — 72 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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