Provider Demographics
NPI:1437974821
Name:KUHFUSS, JENIFER LYNN (LICSW)
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:LYNN
Last Name:KUHFUSS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:LYNN
Other - Last Name:KANIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6120 EARLE BROWN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-4100
Mailing Address - Country:US
Mailing Address - Phone:763-277-1020
Mailing Address - Fax:763-537-7162
Practice Address - Street 1:6120 EARLE BROWN DR STE 100
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-4100
Practice Address - Country:US
Practice Address - Phone:763-277-1020
Practice Address - Fax:763-537-7162
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN229971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical