Individual
MRS. KARISSA MARIE KAUTZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.C.
Contact information
Practice address
2401 46TH AVE SE STE 102, MANDAN, ND 58554-4829
(701) 595-3626
Mailing address
314 E THAYER AVE STE 222, BISMARCK, ND 58501-4018
(701) 595-3626
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1727
ND
101YP2500X
Professional Counselor
Primary
1204-6-15-22A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000
—
ND
Enumeration date
05/30/2014
Last updated
07/14/2025
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