Provider Demographics
NPI:1053758821
Name:KLEINSCHMIDT, KATIE MARIE (MS, LMFT)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:MARIE
Last Name:KLEINSCHMIDT
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3519
Mailing Address - Country:US
Mailing Address - Phone:507-387-3777
Mailing Address - Fax:
Practice Address - Street 1:103 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3519
Practice Address - Country:US
Practice Address - Phone:507-387-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2707106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist