Healthcare Provider Details

I. General information

NPI: 1245388875
Provider Name (Legal Business Name): KRISTEEN JOANNE LAPLANT YOUNG LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEEN JOANNE LAPLANT LPC, LADC

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11505 36TH AVE N
PLYMOUTH MN
55441-2304
US

IV. Provider business mailing address

BOX 555020 BUILDING 1122
CAMP PENDLETON CA
92055-5020
US

V. Phone/Fax

Practice location:
  • Phone: 763-509-3818
  • Fax: 763-559-0149
Mailing address:
  • Phone: 760-725-6338
  • Fax: 760-725-0312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberLPC00042
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLADC300693
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC000214
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: