Provider Demographics
NPI:1477847697
Name:KERLIN, REKA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:REKA
Middle Name:
Last Name:KERLIN
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 1:7755 SPRING LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-5840
Mailing Address - Country:US
Mailing Address - Phone:857-928-9625
Mailing Address - Fax:
Practice Address - Street 1:6550 YORK AVE S STE 503
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2336
Practice Address - Country:US
Practice Address - Phone:952-426-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1477847697Medicaid