Provider Demographics
NPI:1578161758
Name:KROTZ, DARRAH (LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:DARRAH
Middle Name:
Last Name:KROTZ
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5426 NICOLLET AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-2628
Mailing Address - Country:US
Mailing Address - Phone:319-400-5498
Mailing Address - Fax:
Practice Address - Street 1:1619 DAYTON AVE STE 325
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6495
Practice Address - Country:US
Practice Address - Phone:763-228-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2606101YM0800X
MN303954101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)