Provider Demographics
NPI:1821074998
Name:KLEINSCHMIDT, TERESA (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:KLEINSCHMIDT
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 CLIFTON AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3235
Mailing Address - Country:US
Mailing Address - Phone:612-702-1238
Mailing Address - Fax:
Practice Address - Street 1:1665 UTICA AVE S STE 100
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3476
Practice Address - Country:US
Practice Address - Phone:952-541-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1144106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN167719500Medicaid
MN507T3KLOtherBCBS INDIVIDAUL #
MN508T2TEOtherBCBS GROUP