Provider Demographics
NPI:1134412844
Name:KUNDE, LAURA A D (LADC, LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A D
Last Name:KUNDE
Suffix:
Gender:F
Credentials:LADC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 LAKE ST S
Mailing Address - Street 2:#109
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-2639
Mailing Address - Country:US
Mailing Address - Phone:651-982-4792
Mailing Address - Fax:651-982-6035
Practice Address - Street 1:1068 LAKE ST S
Practice Address - Street 2:#109
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2639
Practice Address - Country:US
Practice Address - Phone:651-982-4792
Practice Address - Fax:651-982-6035
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301554101YA0400X
FL4905101YA0400X
FL703192101YA0400X
MN1247106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)