CODY JAMES KIRK
NPI 1073399291
Counselor - Professional in Minnetonka, MN
Active since September 04, 2023
About Cody James Kirk NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CODY JAMES KIRK (NPI 1073399291) is an individual professional provider in Minnetonka, Minnesota, licensed in Minnesota (05350) and active in the NPI registry since September 2023.
NPPES Registry Identity
NPI1073399291
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameCODY JAMES KIRK
Location Address13911 RIDGEDALE DR STE 490Minnetonka, MN 55305-1772
Mailing Address77 Commercial St Apt 531Brooklyn, NY 11222-8043 · (952) 356-6515
Phone(612) 293-5823
Sole ProprietorYes
Enumeration DateSeptember 4, 2023
Last NPPES UpdateMay 27, 20262 updates tracked since enumeration
NPPES CertifiedMay 27, 2026
✔ NPI 1073399291 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · 05350
13911 RIDGEDALE DR STE 490, Minnetonka, MN 55305
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073399291, enumerated as an "individual" on September 04, 2023.
The provider is located at 13911 RIDGEDALE DR STE 490 MINNETONKA, MN 55305 and the phone number is (612) 293-5823.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
