KRISTIN LEE MOEN (NPI# 1457790990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457790990 |
| Entity Type | Individual |
| Full Name | KRISTIN LEE MOEN |
| Other Name | KRISTIN LEE IRWIN |
| Credential | MA, LPCC |
| Practice Address |
13000 63rd Ave N Maple Grove MN 55369-6081 |
| Mailing Address |
12425 River Ridge Blvd Ste 200 Burnsville MN 55337-4872 |
| Practice Telephone | 7635534003 |
| Mailing Telephone | (952) 562-8500 |
| Mailing Fax Number | 9525628801 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
CC00603 | MN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12425 River Ridge Blvd Ste 200, Burnsville, MN 553374872 | (952) 562-8500 | 9525628801 |
| 529 County Road E W, Suite C, Shoreview, MN 551267072 | 9525628310 | 9525628311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093175424 | Kristin Moen | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2016-02-26 |
| 1962739904 | Kristin Moen | Social Worker | 891 Belsly Blvd, Moorhead, MN 56560-5055 | 2009-11-12 |
| Street Address |
13000 63RD AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-6081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538625256 | Jan D'ambrosio Hintze | Counselor | 475 W. Eagle Lake Dr., Maple Grove, MN 55369-5528 | 2019-02-18 |
| 1205348505 | Janell Ruth Johnson | Counselor | 13700 83rd Way N Ste 201, Maple Grove, MN 55369-7015 | 2017-10-27 |
| 1598034324 | Collaborative Counseling LLC | Counselor | 7201 Forestview Ln N, Maple Grove, MN 55369 | 2011-12-22 |
| 1164039905 | Bethany R Dillon | Counselor | 12918 63rd Ave N, Maple Grove, MN 55369-6001 | 2020-09-25 |
| 1649897356 | Christopher Cutler Dozier Jr. | Counselor | 13603 80th Cir N, Maple Grove, MN 55369-8961 | 2020-06-29 |
| 1477103133 | Krystal Billingsley | Counselor | 11334 86th Ave N, Maple Grove, MN 55369-4528 | 2019-09-16 |
| 1376191940 | Lisa Landen Thompson | Counselor | 13603 80th Cir N, Maple Grove, MN 55369-8961 | 2019-08-28 |
| 1164079919 | Grant Soe | Counselor | 13603 80th Cir N, Maple Grove, MN 55369-8961 | 2019-08-26 |
| 1528628872 | Anna Thelen | Counselor | 13603 80th Cir N, Maple Grove, MN 55369-8961 | 2019-06-18 |
| 1285100263 | Lynn Renee Borgmann | Counselor | 12000 Elm Creek Blvd N Ste L70, Maple Grove, MN 55369-7167 | 2018-10-17 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
Please comment or provide details below to improve the information on KRISTIN LEE MOEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.