Provider Demographics
NPI:1306413505
Name:MILLARD, CADIE ALISE (MA, LPCC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CADIE
Middle Name:ALISE
Last Name:MILLARD
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:CADIE
Other - Middle Name:ALISE
Other - Last Name:ENGELKING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3815 15TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1381
Mailing Address - Country:US
Mailing Address - Phone:612-408-1088
Mailing Address - Fax:
Practice Address - Street 1:602 11TH AVE NW STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2297
Practice Address - Country:US
Practice Address - Phone:507-292-1379
Practice Address - Fax:651-383-4929
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2818101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional