Provider Demographics
NPI:1932502804
Name:CARLI BRAUN KODY, PHD, LP, L.L.C.
Entity Type:Organization
Organization Name:CARLI BRAUN KODY, PHD, LP, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CARLI
Authorized Official - Middle Name:BRAUN
Authorized Official - Last Name:KODY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:651-272-9777
Mailing Address - Street 1:700 COMMERCE DR STE 295
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9245
Mailing Address - Country:US
Mailing Address - Phone:651-272-9777
Mailing Address - Fax:
Practice Address - Street 1:700 COMMERCE DR STE 295
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9245
Practice Address - Country:US
Practice Address - Phone:651-272-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 5404103T00000X, 103TC1900X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty