Healthcare Provider Details

I. General information

NPI: 1356261192
Provider Name (Legal Business Name): KRISTIN JURKOWSKI LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 CACTUS CURV
CHANHASSEN MN
55317-9030
US

IV. Provider business mailing address

7310 CACTUS CURV
CHANHASSEN MN
55317-9030
US

V. Phone/Fax

Practice location:
  • Phone: 763-215-2741
  • Fax:
Mailing address:
  • Phone: 763-215-2741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5338
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: