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General NPI Number Information
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NPI Number | 1508997156
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Entity Type | Individual
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Provider Name | KRISTIE ANN MCDONALD LMFT, LADC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 2550 UNIVERSITY AVE W SUITE 229 N
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City | SAINT PAUL
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State | MN
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Zip | 55114-1052
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Country | US
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Telephone | 651-294-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 2669 ALABAMA AVE S
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1701
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Country | US
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Telephone | 612-720-4474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 301947
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1805
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License Number State | MN
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