Healthcare Provider Details

I. General information

NPI: 1528619244
Provider Name (Legal Business Name): ROSANNA KARMOEDDIEN LADC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 MINNESOTA ST STE 1500
SAINT PAUL MN
55101-2269
US

IV. Provider business mailing address

445 MINNESOTA ST STE 1500
SAINT PAUL MN
55101-2269
US

V. Phone/Fax

Practice location:
  • Phone: 952-228-7087
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3688
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number305522
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: