Provider Demographics
NPI:1871897355
Name:KREIDER STARRS, KELSEY SUZANNA (MSW, LICSW, CDW-F)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:SUZANNA
Last Name:KREIDER STARRS
Suffix:
Gender:F
Credentials:MSW, LICSW, CDW-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4732 COLFAX AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5318
Mailing Address - Country:US
Mailing Address - Phone:612-220-2757
Mailing Address - Fax:
Practice Address - Street 1:6 E 45TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-5026
Practice Address - Country:US
Practice Address - Phone:612-220-2757
Practice Address - Fax:612-435-1400
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN193291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical