MEDICARE: CHARTING YOUR SUCCESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1457602781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARTING YOUR SUCCESS LLC

Provider Business Mailing Address
First Line	:	1976 MONTREAL AVENUE
Second Line	:
City	:	ST PAUL
State	:	MN
Zip	:	55116
Country	:	US
Telephone Number	:	612-414-2533
Fax Number	:	651-286-2771

Provider Business Practice Location Address
First Line	:	631 CLEVELAND AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1244
Country	:	US
Telephone Number	:	651-760-3957
Fax Number	:

Authorized Official
Title or Position	:	OWNER, LICSW
Name	:	KENNETH RAYMOND TRAEN
Credential	:	LICSW
Telephone Number	:	612-414-2533

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	09/02/2025

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Directions to “CHARTING YOUR SUCCESS LLC ” Practice Location

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