Provider Demographics
NPI:1871068775
Name:STALPES, KENDRA JO (LPCC, LSW)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:JO
Last Name:STALPES
Suffix:
Gender:F
Credentials:LPCC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-8815
Mailing Address - Country:US
Mailing Address - Phone:320-253-4700
Mailing Address - Fax:763-295-5086
Practice Address - Street 1:407 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362
Practice Address - Country:US
Practice Address - Phone:320-253-4700
Practice Address - Fax:763-295-5086
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health