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Individual
KEVIN GORDON CARLSON
Active
Individual
KEVIN GORDON CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305394
MN
101YP2500X
Professional Counselor
Primary
4790
MN
Other
Enumeration date
01/15/2025
Last updated
02/03/2025
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