MR. KEITH LESLIE DERAAD CPRP
NPI 1063532216
Counselor - Mental Health in Minneapolis, MN

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

Active since March 30, 2007

1825 CHICAGO AVE, MINNEAPOLIS, MN 55404(612) 752-8246(612) 752-8203 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mr. Keith Leslie Deraad Cprp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEITH LESLIE DERAAD CPRP (NPI 1063532216) is an individual mental health provider in Minneapolis, Minnesota and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1063532216

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. KEITH LESLIE DERAADCredential: CPRP

Location Address1825 CHICAGO AVEMinneapolis, MN 55404-1939

Mailing Address3700 W 83rd StBloomington, MN 55431-1063 · (952) 842-8273

Phone(612) 752-8246

Fax(612) 752-8203

Sole ProprietorYes

Enumeration DateMarch 30, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1063532216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

1825 CHICAGO AVE, Minneapolis, MN 55404

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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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