Provider Demographics
NPI:1962466342
Name:SCHOENLEBER, KIRSTEN LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:LOUISE
Last Name:SCHOENLEBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 HAMLINE AVE N STE 607
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-5007
Mailing Address - Country:US
Mailing Address - Phone:651-262-2347
Mailing Address - Fax:651-262-2348
Practice Address - Street 1:2233 HAMLINE AVE N STE 607
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-5007
Practice Address - Country:US
Practice Address - Phone:651-262-2347
Practice Address - Fax:651-262-2348
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0781103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN917271013577OtherBEHAVIORAL HEALTHCARE PRO
MN301K9SCOtherBCBS
MN102654OtherHEALTHPARTNERS
MN6139439OtherUNITED BEHAVIORAL HEALTH