Provider Demographics
NPI:1548548274
Name:KALDAHL, EVE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:MARIE
Last Name:KALDAHL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 PECAN ST
Mailing Address - Street 2:P.O. BOX 723
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-6689
Mailing Address - Country:US
Mailing Address - Phone:651-277-4283
Mailing Address - Fax:651-277-4284
Practice Address - Street 1:5833 PECAN ST
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-6689
Practice Address - Country:US
Practice Address - Phone:651-277-4283
Practice Address - Fax:651-277-4284
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01080OtherLICENSE