Provider Demographics
NPI:1871188631
Name:BARSTOW-BOYER, CATHERINE JEANETTE (LICSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JEANETTE
Last Name:BARSTOW-BOYER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:BARSTOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1789
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:114 MAIN ST N STE 201B
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1819
Practice Address - Country:US
Practice Address - Phone:952-212-8428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical