Provider Demographics
NPI:1710618590
Name:KNIES, TERESA M (LPCC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:M
Last Name:KNIES
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 1:20803 NAPLES ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST BETHEL
Mailing Address - State:MN
Mailing Address - Zip Code:55011-4641
Mailing Address - Country:US
Mailing Address - Phone:651-302-4475
Mailing Address - Fax:
Practice Address - Street 1:2324 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1843
Practice Address - Country:US
Practice Address - Phone:651-644-4100
Practice Address - Fax:651-644-4885
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3351101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health