Provider Demographics
NPI:1194222489
Name:KREIDER STARRS CONSULTING, LLC
Entity Type:Organization
Organization Name:KREIDER STARRS CONSULTING, LLC
Other - Org Name:WATER OF LIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KREIDER STARRS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, CDW-F
Authorized Official - Phone:612-220-2757
Mailing Address - Street 1:4732 COLFAX AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5318
Mailing Address - Country:US
Mailing Address - Phone:612-220-2757
Mailing Address - Fax:612-435-1400
Practice Address - Street 1:6 E 45TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-5026
Practice Address - Country:US
Practice Address - Phone:612-220-2757
Practice Address - Fax:612-435-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN193291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty