Provider Demographics
NPI:1467591578
Name:CAVEN, ELIZABETH JANE (PSY D LP)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JANE
Last Name:CAVEN
Suffix:
Gender:F
Credentials:PSY D LP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JANE
Other - Last Name:WENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2497 7TH AVE E
Mailing Address - Street 2:STE 101
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2946
Mailing Address - Country:US
Mailing Address - Phone:320-396-3333
Mailing Address - Fax:320-396-3363
Practice Address - Street 1:2497 7TH AVE E
Practice Address - Street 2:STE 101
Practice Address - City:NORTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-2946
Practice Address - Country:US
Practice Address - Phone:651-769-6400
Practice Address - Fax:651-769-6449
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4276103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
072K2CAOtherBCBS
6256671OtherUBH
1033890OtherPREFERRED ONE
209785OtherOPTUM
MN437603000Medicaid
HP39059OtherHEALTHPARTNERS
410944710OtherCHAMPUS
209785OtherOPTUM