Provider Demographics
NPI:1003586306
Name:GUNTY, KAI YUKEN (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:KAI
Middle Name:YUKEN
Last Name:GUNTY
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 WASHINGTON DR STE 102
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1388
Mailing Address - Country:US
Mailing Address - Phone:952-913-1776
Mailing Address - Fax:
Practice Address - Street 1:3459 WASHINGTON DR STE 102
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1388
Practice Address - Country:US
Practice Address - Phone:952-913-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2022-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
MN2673101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist