Provider Demographics
NPI:1629519434
Name:KERN, NOEL (LMFT)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:KERN
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 1:2408 FIELD CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4994
Mailing Address - Country:US
Mailing Address - Phone:320-333-9828
Mailing Address - Fax:
Practice Address - Street 1:110 14TH AVE E
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4644
Practice Address - Country:US
Practice Address - Phone:320-202-1400
Practice Address - Fax:320-202-8662
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist