Kristin S. Kildahl, Ma, LP, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP1384 Issued in MN

Legal business name

KRISTIN S. KILDAHL, MA, LP, LLC

Practice address

7200 France Ave S
Edina, MN 55435-4300

Phone

(612) 272-5107

Fax

(651) 730-6657

NPI assigned

Mar 15, 2010

Last updated

Mar 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kristin Skoog Kildahl, MA, LP

Title

Psychologist

Phone

(612) 272-5107

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1669796058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9923 BROOKSIDE CIR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312826",
            "telephone_number": "612-272-5107",
            "fax_number": "651-730-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354300",
            "telephone_number": "612-272-5107",
            "fax_number": "651-730-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN S. KILDAHL, MA, LP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "KILDAHL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "SKOOG",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-272-5107",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI #",
            "identifier": "1578643730",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578643730",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leann Margaret Krezowski, CNP
• Carly Lucille Kriedberg, D.P.M
• Gautham Krishnan
• Jake Joseph Krisik, M.D.
• Megan Marie Kristan, MD
• Marius Kristupaitis, MD
• Jessica Kroeger, DC
• John Joseph Krol, M.D.
• David William Kroll, CRNA
• Lynn Kay Wutschke Kron, LICSW

• Clinical Psychologist in Edina, MN
• Providers in Edina, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.