Individual
LISA KINGSBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
1250 MOORE LAKE DR E STE 200-I, FRIDLEY, MN 55432-5134
(612) 568-8188
Mailing address
3954 3RD AVE S, MINNEAPOLIS, MN 55409-1609
(612) 723-7343
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
CC01426
MN
Other
Enumeration date
02/23/2017
Last updated
03/20/2025
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