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General NPI Number Information
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NPI Number | 1023545258
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Entity Type | Organization
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Legal Business Name | CHRISTINA KRESS, LICSW, LLC
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 05/18/2017
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Provider Practice Location Address
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Address Line | 12301 WHITEWATER DR STE 30
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City | MINNETONKA
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State | MN
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Zip | 55343-4157
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Country | US
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Telephone | 952-223-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 810 CONCORDIA AVE
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City | SAINT PAUL
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State | MN
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Zip | 55104-5522
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Country | US
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Telephone | 202-304-7977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA KRESS
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Credential | MSW, LICSW
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Telephone | 202-304-7977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19016
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License Number State | MN
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