Individual provider Active NPI

Laura A D Kunde, LADC, LMFT

  • Marriage & Family Therapist
  • Forest Lake, MN
National Provider Identifier
1134412844
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1247 Issued in MN
Practice address
1068 Lake St S
#109
Forest Lake, MN 55025-2639
Phone
(651) 982-4792
Fax
(651) 982-6035
NPI assigned
May 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 301554 MN
Addiction (Substance Use Disorder) Counselor 101YA0400X 4905 FL
Addiction (Substance Use Disorder) Counselor 101YA0400X 703192 FL
Marriage & Family Therapist 106H00000X 1247 MN Primary

Addresses

Primary practice location

1068 Lake St S
#109
Forest Lake, MN 55025-2639

Mailing address

1068 Lake St S
#109
Forest Lake, MN 55025-2639
Phone (651) 982-4792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4905FLMDAddiction (Substance Use Disorder) Counselor
703192FLMDAddiction (Substance Use Disorder) Counselor
301554MNMDAddiction (Substance Use Disorder) Counselor
1247MNMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1134412844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 LAKE ST S",
            "address_2": "#109",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252639",
            "telephone_number": "651-982-4792",
            "fax_number": "651-982-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 LAKE ST S",
            "address_2": "#109",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252639",
            "telephone_number": "651-982-4792",
            "fax_number": "651-982-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNDE",
        "first_name": "LAURA",
        "middle_name": "A D",
        "credential": "LADC, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "301554",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "4905",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "703192",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.