Healthcare Provider Details

I. General information

NPI: 1396831962
Provider Name (Legal Business Name): JANE MARIE RAUENHORST PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2239 CARTER AVENUE SUITE 202
SAINT PAUL MN
55108
US

IV. Provider business mailing address

2239 CARTER AVENUE SUITE 202
SAINT PAUL MN
55108
US

V. Phone/Fax

Practice location:
  • Phone: 612-518-4957
  • Fax:
Mailing address:
  • Phone: 612-518-4957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP0403
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: