Healthcare Provider Details

I. General information

NPI: 1871438739
Provider Name (Legal Business Name): KRISTEN MARIE NEISEN LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 LIVINGSTON AVE
WEST ST PAUL MN
55118-3425
US

IV. Provider business mailing address

1016 MINNEHAHA AVE E
SAINT PAUL MN
55106-4644
US

V. Phone/Fax

Practice location:
  • Phone: 651-447-8118
  • Fax:
Mailing address:
  • Phone: 651-447-8118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5568
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: