Provider Demographics
NPI:1386109908
Name:PIKALA, KRISTI (LPCC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:PIKALA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:MICHEL
Other - Last Name:GULLETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:14949 62ND ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6102
Mailing Address - Country:US
Mailing Address - Phone:651-430-6540
Mailing Address - Fax:651-430-6527
Practice Address - Street 1:14949 62ND ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6102
Practice Address - Country:US
Practice Address - Phone:651-430-6540
Practice Address - Fax:651-430-6527
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health