# PEREGRINE PSYCHOTHERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336981125
- **Authorized official:** KATHLEEN MCCARTY (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (608) 213-3280

## Contact information

- **Practice address:** 504 N 17TH AVE E, DULUTH, MN 55812-1240
- **Practice address phone:** (608) 213-3280
- **Mailing address:** 504 N 17TH AVE E, DULUTH, MN 55812-1240
- **Mailing address phone:** (608) 213-3280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |

## Other

- **Enumeration date:** 06/11/2024
- **Last updated:** 06/11/2024