Healthcare Provider Details

I. General information

NPI: 1174955397
Provider Name (Legal Business Name): COUNSELING KIDS AND ADULTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2013
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 10TH ST N STE 220
OAKDALE MN
55128-6160
US

IV. Provider business mailing address

PO BOX 974
LINDSTROM MN
55045-0974
US

V. Phone/Fax

Practice location:
  • Phone: 651-755-4276
  • Fax: 888-972-5307
Mailing address:
  • Phone: 651-755-4276
  • Fax: 888-972-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number302991
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2626
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: CARLA MCKEAN
Title or Position: OWNER/THERAPIST
Credential: M.A. LMFT, LADC
Phone: 651-755-4276