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NPI Code Detail

MEDICARE: CRISTINE MARIE HAIDER LPCC

MEDICARE:   CRISTINE MARIE HAIDER  LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor306391MN
2101YM0800XMental Health Counselor5270MN

General Provider Information

NPI Number : 1376406298
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTINE MARIE HAIDER LPCC
Provider Business Mailing Address
First Line : 10511 CEDAR LAKE RD APT 304
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-3335
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2912 N 2ND ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-1606
Country : US
Telephone Number : 612-234-4242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “ CRISTINE MARIE HAIDER LPCC” Practice Location

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