Healthcare Provider Details

I. General information

NPI: 1770488751
Provider Name (Legal Business Name): GILLIAN CARETTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 UNIVERSITY AVE E
SAINT PAUL MN
55130-4400
US

IV. Provider business mailing address

3727 FOSS RD APT 11
MINNEAPOLIS MN
55421-4521
US

V. Phone/Fax

Practice location:
  • Phone: 651-266-7900
  • Fax:
Mailing address:
  • Phone: 608-417-0954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number307666
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28070
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: