Provider Demographics
NPI:1326773961
Name:KAUFENBERG, MACY (MD)
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:
Last Name:KAUFENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PERSHING AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-2256
Mailing Address - Country:US
Mailing Address - Phone:507-626-8478
Mailing Address - Fax:
Practice Address - Street 1:304 BELLE AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5250
Practice Address - Country:US
Practice Address - Phone:877-877-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health