Provider Demographics
NPI:1962797449
Name:ALMQUIST, KRISTIN LENA (LICSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LENA
Last Name:ALMQUIST
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6375 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2888
Mailing Address - Country:US
Mailing Address - Phone:612-309-4495
Mailing Address - Fax:
Practice Address - Street 1:6375 W 143RD ST
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2888
Practice Address - Country:US
Practice Address - Phone:612-309-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN191331041C0700X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)