Individual
MR. KENNETH L ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
366 PRIOR AVE N, SAINT PAUL, MN 55104-5165
(651) 644-1304
Mailing address
366 PRIOR AVE N, SAINT PAUL, MN 55104-5165
(651) 644-1304
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302801
MN
101YM0800X
Mental Health Counselor
1590
MN
101YM0800X
Mental Health Counselor
Primary
LC16525
MD
Other
Enumeration date
03/08/2010
Last updated
02/17/2026
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