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NPI Code Detail

MEDICARE: LENAYA TERRILL KERLIN LPCC

MEDICARE: LENAYA TERRILL KERLIN LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorCC02122MN

General Provider Information

NPI Number : 1619535192
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENAYA TERRILL KERLIN LPCC
Provider Business Mailing Address
First Line : 725 PARKSIDE DR
Second Line :
City : VADNAIS HEIGHTS
State : MN
Zip : 55127-3651
Country : US
Telephone Number : 701-351-5383
Fax Number :
Provider Business Practice Location Address
First Line : 275 4TH ST E STE 301
Second Line :
City : SAINT PAUL
State : MN
Zip : 55101-1771
Country : US
Telephone Number : 612-314-5867
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2019
Last Update Date : 06/05/2019

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Directions to “ LENAYA TERRILL KERLIN LPCC” Practice Location

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