Provider Demographics
NPI:1679258123
Name:KLINDT, JULI KAY (BS, LADC)
Entity type:Individual
Prefix:
First Name:JULI
Middle Name:KAY
Last Name:KLINDT
Suffix:
Gender:F
Credentials:BS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20545 COUNTY ROAD 1 NW
Mailing Address - Street 2:
Mailing Address - City:PENNOCK
Mailing Address - State:MN
Mailing Address - Zip Code:56279-9687
Mailing Address - Country:US
Mailing Address - Phone:612-968-6204
Mailing Address - Fax:
Practice Address - Street 1:1125 6TH ST SE
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4675
Practice Address - Country:US
Practice Address - Phone:320-235-4613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301660101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)