# LAKE AND VALLEY FAMILY THERAPY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578262333
- **Authorized official:** NATASHA KELLER LMFT (OWNER)
- **Authorized official phone:** (651) 360-1995

## Contact information

- **Practice address:** 2179 4TH ST STE 2F, WHITE BEAR LAKE, MN 55110-3041
- **Practice address phone:** (651) 360-1995
- **Practice address fax:** (651) 666-1379
- **Mailing address:** 2179 4TH ST STE 2B, WHITE BEAR LAKE, MN 55110-3041
- **Mailing address phone:** (651) 360-1995
- **Mailing address fax:** (651) 666-1379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/01/2023
- **Last updated:** 08/12/2026