Healthcare Provider Details

I. General information

NPI: 1093628968
Provider Name (Legal Business Name): KATY LENTZ MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1564 COUNTY ROAD 134
SAINT CLOUD MN
56303-0346
US

IV. Provider business mailing address

7363 PARSON AVE NE
OTSEGO MN
55330-6682
US

V. Phone/Fax

Practice location:
  • Phone: 320-229-4950
  • Fax:
Mailing address:
  • Phone: 320-229-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33287
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: