Provider Demographics
NPI:1184670275
Name:KARIS, TERRI ANN (MA, LP,PH D, LMFT)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:ANN
Last Name:KARIS
Suffix:
Gender:F
Credentials:MA, LP,PH D, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3009 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2628
Practice Address - Country:US
Practice Address - Phone:612-718-5113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3839103T00000X
WI621-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3839OtherLICENSED PSYCHOLOGIST
WI621-124OtherLMFT
MN3839OtherLICENSED PSYCHOLOGIST