Provider Demographics
NPI:1871267856
Name:DESCHENE, KATRINA (LPCC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:DESCHENE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:A
Other - Last Name:STOLLENWERK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1010 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5001
Mailing Address - Country:US
Mailing Address - Phone:218-233-7524
Mailing Address - Fax:218-233-8627
Practice Address - Street 1:1010 32ND AVE S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5001
Practice Address - Country:US
Practice Address - Phone:218-233-7524
Practice Address - Fax:218-233-8627
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2556101YP2500X
MN04114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional