Healthcare Provider Details

I. General information

NPI: 1770155640
Provider Name (Legal Business Name): CATHERINE CICH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 02/02/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 W FRANKLIN AVE STE 2
MINNEAPOLIS MN
55405-3624
US

IV. Provider business mailing address

5125 COUNTY ROAD 101 STE 300
MINNETONKA MN
55345-4157
US

V. Phone/Fax

Practice location:
  • Phone: 763-218-3787
  • Fax:
Mailing address:
  • Phone: 952-932-7277
  • Fax: 952-932-9827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number27662
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: