Provider Demographics
NPI:1679977326
Name:KAREL, JENNIFER D (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:D
Last Name:KAREL
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:D
Other - Last Name:MATTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, LP
Mailing Address - Street 1:1123 GRAND AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2629
Mailing Address - Country:US
Mailing Address - Phone:651-287-0931
Mailing Address - Fax:651-287-0967
Practice Address - Street 1:1123 GRAND AVE STE 301
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2629
Practice Address - Country:US
Practice Address - Phone:651-287-0931
Practice Address - Fax:651-287-0967
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5822103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical