Healthcare Provider Details

I. General information

NPI: 1053006619
Provider Name (Legal Business Name): KRYSTLE HAUGEN, LMFT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W 2ND ST STE 448
DULUTH MN
55802-1920
US

IV. Provider business mailing address

205 W 2ND ST STE 448
DULUTH MN
55802-1920
US

V. Phone/Fax

Practice location:
  • Phone: 218-480-0145
  • Fax:
Mailing address:
  • Phone: 218-480-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KRYSTLE HAUGEN
Title or Position: OWNER
Credential: LPCC
Phone: 218-480-0145