Individual
KEVIN GORDON CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC, LADC
Contact information
Practice address
520 OSBORNE RD NE STE 120, FRIDLEY, MN 55432-2718
(763) 236-4300
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
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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