Provider Demographics
NPI:1508122367
Name:CLAUSEN, LINDA DOLS (LMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DOLS
Last Name:CLAUSEN
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 1:17570 VERGUS AVE
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:MN
Mailing Address - Zip Code:55352-9348
Mailing Address - Country:US
Mailing Address - Phone:612-709-0272
Mailing Address - Fax:
Practice Address - Street 1:17570 VERGUS AVE
Practice Address - Street 2:
Practice Address - City:JORDAN
Practice Address - State:MN
Practice Address - Zip Code:55352-9348
Practice Address - Country:US
Practice Address - Phone:612-709-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1599106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist