Provider Demographics
NPI:1588824890
Name:RYNDERS, CAROL BETH (LICSW)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:BETH
Last Name:RYNDERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2829 UNIVERSITY AVE SE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3230
Mailing Address - Country:US
Mailing Address - Phone:612-767-3881
Mailing Address - Fax:612-870-3772
Practice Address - Street 1:2025 NICOLLET AVE
Practice Address - Street 2:SUITE 200B
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2552
Practice Address - Country:US
Practice Address - Phone:612-767-3881
Practice Address - Fax:612-870-3772
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN076131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical