Provider Demographics
NPI:1710482310
Name:KIMREY-REID, CATHERINE JOAN (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOAN
Last Name:KIMREY-REID
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 INGLEWOOD AVE SW
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-4015
Mailing Address - Country:US
Mailing Address - Phone:612-380-7353
Mailing Address - Fax:
Practice Address - Street 1:7300 147TH ST W STE 204
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7850
Practice Address - Country:US
Practice Address - Phone:952-997-3020
Practice Address - Fax:507-934-2654
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional