Provider Demographics
NPI:1770039547
Name:KLINNERT, DEBORAH (LPCC, LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:KLINNERT
Suffix:
Gender:F
Credentials:LPCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3239
Mailing Address - Country:US
Mailing Address - Phone:307-401-1188
Mailing Address - Fax:
Practice Address - Street 1:931 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6150
Practice Address - Country:US
Practice Address - Phone:307-401-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1636101Y00000X
MN3216101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor