Healthcare Provider Details

I. General information

NPI: 1831069756
Provider Name (Legal Business Name): CARDINAL KANE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 COLLEEN AVE
SHOREVIEW MN
55126-6201
US

IV. Provider business mailing address

190 COLLEEN AVE
SHOREVIEW MN
55126-6201
US

V. Phone/Fax

Practice location:
  • Phone: 651-286-9339
  • Fax:
Mailing address:
  • Phone: 651-286-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ASHLEIGH D SHEAK KANE
Title or Position: OWNER
Credential: LPCC LADC
Phone: 651-286-9339