Provider Demographics
NPI:1225488315
Name:KANE, KRISTIN CELINE (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:CELINE
Last Name:KANE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 MORGAN AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1107
Mailing Address - Country:US
Mailing Address - Phone:651-210-7405
Mailing Address - Fax:
Practice Address - Street 1:275 4TH ST E
Practice Address - Street 2:301
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1696
Practice Address - Country:US
Practice Address - Phone:651-210-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3132106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist