Provider Demographics
NPI:1225434426
Name:NORDGREN, KAY (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:
Last Name:NORDGREN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8980 DARNEL RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1911
Mailing Address - Country:US
Mailing Address - Phone:952-486-3965
Mailing Address - Fax:952-974-9470
Practice Address - Street 1:9352 OAK AVE
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-9422
Practice Address - Country:US
Practice Address - Phone:952-955-4714
Practice Address - Fax:952-955-6213
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-15
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional