Provider Demographics
NPI:1497733927
Name:BOGEL, CAROLINE ELISABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ELISABETH
Last Name:BOGEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14789 OREN RD N
Mailing Address - Street 2:
Mailing Address - City:SCANDIA
Mailing Address - State:MN
Mailing Address - Zip Code:55073-9433
Mailing Address - Country:US
Mailing Address - Phone:651-202-5515
Mailing Address - Fax:
Practice Address - Street 1:CHILDRENS HEALTH CARE
Practice Address - Street 2:345 N. SMITH AVE
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-220-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical