Kristin Southworth
Counselor, Mental Health in Plymouth, MN. Individual provider (NPI-1).
NPI number1962040469
StatusActive
Last updated in NPPESJan 6, 2023
Details
- NPI
- 1962040469
- Entity type
- Individual (NPI-1)
- Name
- Kristin Southworth
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 16, 2019
- Certification date
- Jan 6, 2023
- Last updated
- Jan 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 2296 | MN | Yes |
Practice location
18205 45th Ave N Ste CPlymouth, MN 55446-4594
Phone 651-478-4099
Mailing address
868 Carroll AveSaint Paul, MN 55104-5411
Other practice locations
2724 University Ave Se
Minneapolis, MN 55414-3210
Minneapolis, MN 55414-3210
Phone 612-299-1090
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All 52 Mental Health Counselor providers in Plymouth · All 1,953 providers in Plymouth
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