Provider Demographics
NPI:1891878310
Name:MUNSEN, KRISTIE L (LPC-MH)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:L
Last Name:MUNSEN
Suffix:
Gender:F
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 8TH AVE NW STE 333
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-2700
Mailing Address - Country:US
Mailing Address - Phone:605-225-3622
Mailing Address - Fax:605-229-2719
Practice Address - Street 1:405 8TH AVE NW STE 333
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401
Practice Address - Country:US
Practice Address - Phone:605-225-3622
Practice Address - Fax:605-229-2719
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health