Healthcare Provider Details

I. General information

NPI: 1962371146
Provider Name (Legal Business Name): STEPHANIE KUGLIN MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 3RD AVE SE STE 408
ROCHESTER MN
55904-4613
US

IV. Provider business mailing address

2220 40TH AVE SE
ROCHESTER MN
55904-6046
US

V. Phone/Fax

Practice location:
  • Phone: 507-517-8580
  • Fax: 507-208-4150
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5230
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: