Provider Demographics
NPI:1417648858
Name:REICHOW, KASEY MARIE (MA LAMFT)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:MARIE
Last Name:REICHOW
Suffix:
Gender:F
Credentials:MA LAMFT
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:MARIE
Other - Last Name:BAHNEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4947 EMMIT DR N UNIT 4
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-8556
Mailing Address - Country:US
Mailing Address - Phone:651-352-0755
Mailing Address - Fax:
Practice Address - Street 1:7041 20TH AVE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MN
Practice Address - Zip Code:55038-9737
Practice Address - Country:US
Practice Address - Phone:612-924-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4627106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist