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General NPI Number Information
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NPI Number | 1194222489
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Entity Type | Organization
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Legal Business Name | KREIDER STARRS CONSULTING, LLC
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 6 E 45TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-5026
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Country | US
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Telephone | 612-220-2757
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Fax | 612-435-1400
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Provider Business Mailing Address
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Address Line | 4732 COLFAX AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-5318
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Country | US
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Telephone | 612-220-2757
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Fax | 612-435-1400
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Authorized Official
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Title or Position | OWNER
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Name | KELSEY KREIDER STARRS
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Credential | MSW, LICSW, CDW-F
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Telephone | 612-220-2757
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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 | 19329
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License Number State | MN
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