Individual
MISTY JEANNE COONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
1107 HAZELTINE BLVD STE 370, CHASKA, MN 55318-1009
(952) 395-1441
(952) 395-1442
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305416
MN
101YP2500X
Professional Counselor
Primary
3905
MN
Other
Enumeration date
09/23/2020
Last updated
11/04/2025
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