Healthcare Provider Details

I. General information

NPI: 1639851322
Provider Name (Legal Business Name): CATHERINE MOLENAAR MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 UNIVERSITY AVE W
SAINT PAUL MN
55114-1052
US

IV. Provider business mailing address

7041 HIGHOVER CT S
CHANHASSEN MN
55317-7569
US

V. Phone/Fax

Practice location:
  • Phone: 651-647-1900
  • Fax:
Mailing address:
  • Phone: 612-709-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3964
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: