Provider Demographics
NPI:1114463973
Name:HOPPE, KRISTIN (LADC, LPCC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HOPPE
Suffix:
Gender:F
Credentials:LADC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1903
Mailing Address - Country:US
Mailing Address - Phone:612-752-8000
Mailing Address - Fax:612-752-8001
Practice Address - Street 1:13100 WAYZATA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1810
Practice Address - Country:US
Practice Address - Phone:952-206-2040
Practice Address - Fax:952-206-2041
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302254101YA0400X
MNCC2320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)