MEDICARE: MS. DENISE ANN KAUTZER MA, LPCC

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	101YM0800X	Mental Health Counselor	LPCC00809	MN

General Provider Information

NPI Number	:	1851550586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE ANN KAUTZER MA, LPCC

Provider Business Mailing Address
First Line	:	570 ASBURY ST STE 206
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1850
Country	:	US
Telephone Number	:	651-214-4650
Fax Number	:	651-964-2780

Provider Business Practice Location Address
First Line	:	570 ASBURY ST STE 206
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1850
Country	:	US
Telephone Number	:	651-214-4650
Fax Number	:	651-964-2780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2008
Last Update Date	:	07/21/2022

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