Provider Demographics
NPI:1194282210
Name:SCHLIESMAN, KATHERINE L (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:SCHLIESMAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5936 BEARD AVE S
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55410-2710
Mailing Address - Country:US
Mailing Address - Phone:612-270-9861
Mailing Address - Fax:
Practice Address - Street 1:14300 NICOLLET CT STE 130
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-3422
Practice Address - Country:US
Practice Address - Phone:952-435-8814
Practice Address - Fax:952-435-7705
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3075106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist