Provider Demographics
NPI:1831644756
Name:FREY, KALEIGH (LPCC)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:FREY
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 1:1027 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-7037
Mailing Address - Country:US
Mailing Address - Phone:218-556-7648
Mailing Address - Fax:
Practice Address - Street 1:5985 RICE CREEK PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-5038
Practice Address - Country:US
Practice Address - Phone:218-556-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1759101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health