Individual provider · Type 1 NPI

Kevin Gordon Carlson, LPCC, LADC

Professional Counselor · Fridley, MN

NPI number 1205647740 Active

Practice location

520 Osborne Rd NE Ste 120
Fridley, MN 55432-2718

Call (763) 236-4300 Map

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X305394 (MN)
Professional Counselor Primary 101YP2500X4790 (MN)

Professional Counselor: Definition to come...

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About NPI 1205647740

Kevin Gordon Carlson, LPCC, LADC's National Provider Identifier is 1205647740, issued on Jan 15, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Fridley, MN. The record was last updated on Feb 3, 2025.