Provider Demographics
NPI:1578815288
Name:ASCHENAKI, KRYSTLE A (LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:A
Last Name:ASCHENAKI
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:
Other - First Name:KRYSTLE
Other - Middle Name:
Other - Last Name:GALLEGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC
Mailing Address - Street 1:1246 UNIVERSITY AVE W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4125
Mailing Address - Country:US
Mailing Address - Phone:651-404-2000
Mailing Address - Fax:
Practice Address - Street 1:1246 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4125
Practice Address - Country:US
Practice Address - Phone:763-390-9289
Practice Address - Fax:651-666-2914
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303273101YA0400X
MN2405101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)