Healthcare Provider Details

I. General information

NPI: 1356831051
Provider Name (Legal Business Name): KARA PILON REIL COUNSELING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 REPUBLIC AVE
ST LOUIS PARK MN
55426-4154
US

IV. Provider business mailing address

3340 REPUBLIC AVE
ST LOUIS PARK MN
55426-4154
US

V. Phone/Fax

Practice location:
  • Phone: 763-559-7050
  • Fax:
Mailing address:
  • Phone: 612-567-7364
  • Fax: 612-926-8526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00201
License Number StateMN

VIII. Authorized Official

Name: KARA E PILON REIL
Title or Position: LICENSED PROF. CLINICAL COUNSELOR
Credential: M.A., LPCC
Phone: 612-388-9602