Provider Demographics
NPI:1831513282
Name:GOEDEN, KARI LISABETH (LMFT)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:LISABETH
Last Name:GOEDEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 WELCOME AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2043
Mailing Address - Country:US
Mailing Address - Phone:763-479-9568
Mailing Address - Fax:
Practice Address - Street 1:8401 WAYZATA BLVD
Practice Address - Street 2:370
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1343
Practice Address - Country:US
Practice Address - Phone:763-544-1006
Practice Address - Fax:763-544-1008
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2648106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist