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General NPI Number Information
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NPI Number | 1831644756
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Entity Type | Individual
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Provider Name | KALEIGH FREY LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/20/2016
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Last Update Date | 08/06/2022
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Provider Practice Location Address
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Address Line | 5985 RICE CREEK PKWY SUITE 201
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City | SHOREVIEW
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State | MN
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Zip | 55126-5038
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Country | US
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Telephone | 218-556-7648
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 PORTLAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55104-7037
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Country | US
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Telephone | 218-556-7648
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1759
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License Number State | MN
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