Provider Demographics
NPI:1144048323
Name:CARUFEL, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:CARUFEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11192 STONEMILL FARMS CURV
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5203
Mailing Address - Country:US
Mailing Address - Phone:612-644-8088
Mailing Address - Fax:
Practice Address - Street 1:8085 WAYZATA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1461
Practice Address - Country:US
Practice Address - Phone:612-296-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health