Provider Demographics
NPI:1073047395
Name:KURTTI, CARLYSS ANN (LPC, LPCC)
Entity type:Individual
Prefix:MS
First Name:CARLYSS
Middle Name:ANN
Last Name:KURTTI
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:MS
Other - First Name:CARLYSS
Other - Middle Name:ANN
Other - Last Name:NEUFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LPCC
Mailing Address - Street 1:8263 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:MYLO
Mailing Address - State:ND
Mailing Address - Zip Code:58353-9431
Mailing Address - Country:US
Mailing Address - Phone:701-550-0105
Mailing Address - Fax:
Practice Address - Street 1:8263 53RD AVE
Practice Address - Street 2:
Practice Address - City:MYLO
Practice Address - State:ND
Practice Address - Zip Code:58353-9431
Practice Address - Country:US
Practice Address - Phone:701-550-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK201995101YP2500X
MNCC00992101YP2500X, 101YP2500X
ND619-11-1-08-223101YP2500X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health