Provider Demographics
NPI:1356020846
Name:TERHAAR, KELSEY (LMSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:TERHAAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:MILHAUPT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9859
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58106-9859
Mailing Address - Country:US
Mailing Address - Phone:701-451-4900
Mailing Address - Fax:651-925-0057
Practice Address - Street 1:20 1ST ST SW STE 250
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3851
Practice Address - Country:US
Practice Address - Phone:701-852-3328
Practice Address - Fax:651-925-0057
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6555104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker