Provider Demographics
NPI:1952146789
Name:COONROD, KRISTEN (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:COONROD
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 1:5700 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2535
Mailing Address - Country:US
Mailing Address - Phone:651-249-3621
Mailing Address - Fax:
Practice Address - Street 1:7505 METRO BLVD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-3081
Practice Address - Country:US
Practice Address - Phone:651-271-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist