Healthcare Provider Details

I. General information

NPI: 1467591578
Provider Name (Legal Business Name): ELIZABETH JANE CAVEN PSY D LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH JANE WENGER

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2497 7TH AVE E STE 101
NORTH ST PAUL MN
55109-2946
US

IV. Provider business mailing address

2497 7TH AVE E STE 101
NORTH ST PAUL MN
55109-2946
US

V. Phone/Fax

Practice location:
  • Phone: 651-769-6400
  • Fax: 651-769-6449
Mailing address:
  • Phone: 320-396-3333
  • Fax: 320-396-3363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP4276
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: