Provider Demographics
NPI:1225196512
Name:KATHRYN ZOFF SEIVERT PHD LP PA
Entity Type:Organization
Organization Name:KATHRYN ZOFF SEIVERT PHD LP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIC PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOFF-SEIVERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LP
Authorized Official - Phone:651-388-6459
Mailing Address - Street 1:854 SO. ROBERT ST.
Mailing Address - Street 2:
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-3258
Mailing Address - Country:US
Mailing Address - Phone:651-388-6459
Mailing Address - Fax:952-241-9225
Practice Address - Street 1:2000 OLD WEST MAIN
Practice Address - Street 2:SUITE 329
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-1993
Practice Address - Country:US
Practice Address - Phone:651-388-6459
Practice Address - Fax:952-241-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMNLP0699103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty