Healthcare Provider Details

I. General information

NPI: 1922935782
Provider Name (Legal Business Name): CARLY ROHLFING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6425 W 33RD ST
ST LOUIS PARK MN
55426-3403
US

IV. Provider business mailing address

10 DORSET RD
MENDOTA HEIGHTS MN
55118-1916
US

V. Phone/Fax

Practice location:
  • Phone: 952-928-6279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number22062
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: