KRISTAL ROSE MCKENZIE LADC
NPI 1073047056
Counselor - Addiction (Substance Use Disorder) in Saint Louis Park, MN
About Kristal Rose Mckenzie Ladc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRISTAL ROSE MCKENZIE LADC (NPI 1073047056) is an individual addiction (substance use disorder) provider in Saint Louis Park, Minnesota, licensed in Minnesota (303641) and active in the NPI registry since April 2017.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINNEAPOLIS, MN 55426
ST LOUIS PARK, MN 55426
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kristal Mckenzie's NPI number?
The NPI number for Kristal Mckenzie is 1073047056. It was assigned to this individual provider in the NPPES registry on April 17, 2017. The provider is also known as Kristal Rose Hahn Ladc.
Where is Kristal Mckenzie located?
Kristal Mckenzie practices at 3381 Gorham Ave, Saint Louis Park, MN 55426. The listed phone number is (952) 926-2600.
What is Kristal Mckenzie's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.
When was this NPI record last updated?
The NPPES record for Kristal Mckenzie was last updated on April 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kristal Rose Mckenzie, LADC · NPI 1073047056
Addiction (Substance Use Disorder) provider in Saint Louis Park, Minnesota. Individual provider, active in the CMS NPPES registry since April 17, 2017.
## Identity
- **NPI:** 1073047056 (Entity type: Individual)
- **Enumerated:** April 17, 2017
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **State license:** 303641 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 3381 GORHAM AVE, Saint Louis Park, MN 55426-4240
- **Phone:** (952) 926-2600
## Record status
- **NPPES last updated:** April 17, 2017
- **Other identifiers:** Other 1972927879 (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1073047056) · Data from the CMS NPPES public registry.