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NPI Code Detail

MEDICARE: KRISTINA BRAATEN MD, LPCC, LADC

MEDICARE: KRISTINA BRAATEN MD, LPCC, LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor305602MN
2101YP2500XProfessional CounselorCC03297MN
3207ZP0102XAnatomic Pathology & Clinical Pathology Physician61967MN
4101YM0800XMental Health CounselorCC03297MN

General Provider Information

NPI Number : 1689664187
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA BRAATEN MD, LPCC, LADC
Provider Business Mailing Address
First Line : 201 WINDSOR CT
Second Line :
City : NEW BRIGHTON
State : MN
Zip : 55112-3367
Country : US
Telephone Number : 715-651-3125
Fax Number :
Provider Business Practice Location Address
First Line : 909 FULTON ST SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55455-4800
Country : US
Telephone Number : 612-273-8383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 08/28/2025

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