Basic Information
| Provider Information | |||||||||
| NPI: | 1629543293 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDEN | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | MSW, LGSW | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | HARDEN | ||||||||
| OtherFirstName: | KATIE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MSW, LGSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 14115 JAMES RD STE 305 | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553749417 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 14115 JAMES RD STE 305 | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553749417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635758086 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2018 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 21439 | MN | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.