Provider Demographics
NPI:1457651044
Name:KREOFSKY COUNSELING SERVICES
Entity Type:Organization
Organization Name:KREOFSKY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:952-929-2569
Mailing Address - Street 1:7200 FRANCE AVE S
Mailing Address - Street 2:SUITE 223
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4300
Mailing Address - Country:US
Mailing Address - Phone:952-452-4851
Mailing Address - Fax:952-405-8727
Practice Address - Street 1:7200 FRANCE AVE S
Practice Address - Street 2:SUITE 223
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4300
Practice Address - Country:US
Practice Address - Phone:952-452-4851
Practice Address - Fax:952-405-8727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1814106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty