Provider Demographics
NPI:1295617983
Name:COLSRUD, CATHERINE (LICSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:COLSRUD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AAZHOOMOG CLINIC
Mailing Address - Street 2:45741 GRACE LAKE RD
Mailing Address - City:SANDSTONE
Mailing Address - State:MN
Mailing Address - Zip Code:55072
Mailing Address - Country:US
Mailing Address - Phone:320-384-0149
Mailing Address - Fax:
Practice Address - Street 1:AAZHOOMOG CLINIC
Practice Address - Street 2:45741 GRACE LAKE RD
Practice Address - City:SANDSTONE
Practice Address - State:MN
Practice Address - Zip Code:55072
Practice Address - Country:US
Practice Address - Phone:320-384-0149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN313661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical