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KRISTIN LEE MOEN MA, LPCC
NPI 1457790990
Counselor - Mental Health in Maple Grove, MN

Active since June 18, 2013
13000 63RD AVE N, MAPLE GROVE, MN 55369(763) 553-4003 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jul 7, 2017 (3 updates tracked since 2017).

About Kristin Lee Moen Ma, Lpcc NPPES

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

KRISTIN LEE MOEN MA, LPCC (NPI 1457790990) is an individual mental health provider in Maple Grove, Minnesota, licensed in Minnesota (CC00603) and active in the NPI registry since June 2013. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1457790990
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKRISTIN LEE MOENCredential: MA, LPCC
Location Address13000 63RD AVE NMaple Grove, MN 55369-6081
Mailing Address12425 River Ridge Blvd Ste 200Burnsville, MN 55337-4872 · (952) 562-8500 · Fax (952) 562-8801
Phone(763) 553-4003
Sole ProprietorNo
Enumeration DateJune 18, 2013
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1457790990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MN · CC00603
13000 63RD AVE N, Maple Grove, MN 55369
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Other Names 1

Former Name (1)Kristin Lee Irwin Ma, Lpcc

Secondary Practice Locations 2

Location 1529 County Road E W, Suite CShoreview, MN 55126-7072 · Phone (952) 562-8310 · Fax (952) 562-8311
Location 212425 River Ridge Blvd Ste 200Burnsville, MN 55337-4872 · Phone (952) 562-8500 · Fax (952) 562-8801

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 Kristin Moen's NPI number?

The NPI number for Kristin Moen is 1457790990. It was assigned to this individual provider in the NPPES registry on June 18, 2013. The provider is also known as Kristin Lee Irwin Ma, Lpcc.

Where is Kristin Moen located?

Kristin Moen practices at 13000 63rd Ave N, Maple Grove, MN 55369. The listed phone number is (763) 553-4003.

What is Kristin Moen's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Kristin Moen was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.