Provider Demographics
NPI:1306579453
Name:WILLPRECHT, KAYLIE MAE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:KAYLIE
Middle Name:MAE
Last Name:WILLPRECHT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:KAYLIE
Other - Middle Name:MAE
Other - Last Name:SCHRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1789
Mailing Address - Country:US
Mailing Address - Phone:651-628-9566
Mailing Address - Fax:651-628-0411
Practice Address - Street 1:112 1ST ST W
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4002
Practice Address - Country:US
Practice Address - Phone:218-888-8032
Practice Address - Fax:218-888-8033
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional