Provider Demographics
NPI:1942949722
Name:STROBL-REICHEL, KRISTINE (LICSW)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:STROBL-REICHEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 HUMBOLDT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-1632
Mailing Address - Country:US
Mailing Address - Phone:612-220-5136
Mailing Address - Fax:
Practice Address - Street 1:3400 W 66TH ST STE 400
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2134
Practice Address - Country:US
Practice Address - Phone:952-914-1703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN259661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical