Provider Demographics
NPI:1124741921
Name:KUPFER RUUD, CHRISTINA ANN (MA, LPCC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANN
Last Name:KUPFER RUUD
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ANN
Other - Last Name:KUPFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2365 ARIEL ST N
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2248
Mailing Address - Country:US
Mailing Address - Phone:612-895-4575
Mailing Address - Fax:
Practice Address - Street 1:2365 ARIEL ST N
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2248
Practice Address - Country:US
Practice Address - Phone:612-895-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5214101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional