Provider Demographics
NPI:1720146376
Name:HUSEBY, KATHY JO (MS LMFO)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:JO
Last Name:HUSEBY
Suffix:
Gender:F
Credentials:MS LMFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 1/2N MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-1728
Mailing Address - Country:US
Mailing Address - Phone:507-354-1144
Mailing Address - Fax:507-359-3764
Practice Address - Street 1:28 HALF N MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1728
Practice Address - Country:US
Practice Address - Phone:507-354-1144
Practice Address - Fax:507-359-3764
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1323101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN124404OtherU CARE
MN23032HUOtherBLUE CROSS BLUE SHIELD