Provider Demographics
NPI:1457538696
Name:DIOCESE OF NEW ULM
Entity Type:Organization
Organization Name:DIOCESE OF NEW ULM
Other - Org Name:DIOCESE OF NEW ULM - CATHOLIC CHARITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KEAVENY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:507-359-2617
Mailing Address - Street 1:1421 6TH STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-2057
Mailing Address - Country:US
Mailing Address - Phone:866-670-5163
Mailing Address - Fax:507-354-0268
Practice Address - Street 1:1421 6TH STREET NORTH
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-2057
Practice Address - Country:US
Practice Address - Phone:866-670-5153
Practice Address - Fax:507-354-0268
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIOCESE OF NEW ULM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-30
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN89001041C0700X
MN188061041C0700X
MN1098106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty