Provider Demographics
NPI:1851550586
Name:KAUTZER, DENISE ANN (MA, LPCC)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANN
Last Name:KAUTZER
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 ASBURY ST STE 206
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1850
Mailing Address - Country:US
Mailing Address - Phone:651-214-4650
Mailing Address - Fax:651-964-2780
Practice Address - Street 1:570 ASBURY ST STE 206
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-1850
Practice Address - Country:US
Practice Address - Phone:651-214-4650
Practice Address - Fax:651-964-2780
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPCC00809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health