Provider Demographics
NPI:1386200905
Name:WARNER, CAROLINA FAYE (LMFT)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:FAYE
Last Name:WARNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 6TH ST SE
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347-1733
Mailing Address - Country:US
Mailing Address - Phone:320-219-1821
Mailing Address - Fax:
Practice Address - Street 1:200 4TH ST NE
Practice Address - Street 2:
Practice Address - City:STAPLES
Practice Address - State:MN
Practice Address - Zip Code:56479-2428
Practice Address - Country:US
Practice Address - Phone:218-894-1002
Practice Address - Fax:218-894-0131
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3590106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist