Individual provider · Type 1 NPI

Kellan Vencil

Professional Counselor · Andover, MN

NPI number 1083143655 Active

Practice location

1875 Station Pkwy NW
Andover, MN 55304-3319

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XP-1400 (NE)
Professional Counselor Primary 101YP2500XCC02700 (MN)

Professional Counselor: Definition to come...

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About NPI 1083143655

Kellan Vencil's National Provider Identifier is 1083143655, issued on Jun 7, 2017. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Andover, MN. The record was last updated on Jul 15, 2022.