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NPI Code Detail

MEDICARE: KATHRYN OCANAS

MEDICARE:   KATHRYN  OCANAS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor304979MN
2101Y00000XCounselor2987MN

General Provider Information

NPI Number : 1568323004
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN OCANAS
Provider Business Mailing Address
First Line : 19355 OXBORO AVE N
Second Line :
City : MARINE ON SAINT CROIX
State : MN
Zip : 55047-9653
Country : US
Telephone Number : 612-308-3242
Fax Number :
Provider Business Practice Location Address
First Line : 19355 OXBORO AVE N
Second Line :
City : MARINE ON SAINT CROIX
State : MN
Zip : 55047-9653
Country : US
Telephone Number : 612-308-3242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2025
Last Update Date : 12/12/2025

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