MEDICARE: KRISTEN MARIE NEISEN 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
1	101YM0800X	Mental Health Counselor	5568	MN

General Provider Information

NPI Number	:	1871438739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN MARIE NEISEN LPCC, LADC

Provider Business Mailing Address
First Line	:	1016 MINNEHAHA AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-4644
Country	:	US
Telephone Number	:	651-447-8118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 LIVINGSTON AVE
Second Line	:
City	:	WEST ST PAUL
State	:	MN
Zip	:	55118-3425
Country	:	US
Telephone Number	:	651-447-8118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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