Provider Demographics
NPI:1407561814
Name:STOCKDALE, NATALEE KAY (MA, ATRBC, LPCC, NCC)
Entity type:Individual
Prefix:
First Name:NATALEE
Middle Name:KAY
Last Name:STOCKDALE
Suffix:
Gender:F
Credentials:MA, ATRBC, LPCC, NCC
Other - Prefix:
Other - First Name:NATALEE
Other - Middle Name:
Other - Last Name:STOCKDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, ATRBC, LPCC, NCC
Mailing Address - Street 1:1794 MCKUSICK ROAD CT N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-9608
Mailing Address - Country:US
Mailing Address - Phone:612-615-4065
Mailing Address - Fax:
Practice Address - Street 1:1794 MCKUSICK ROAD CT N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-9608
Practice Address - Country:US
Practice Address - Phone:612-615-4065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MN4040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health