Individual
KEVIN SPADING
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 379-0444
(651) 379-0434
Mailing address
8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 379-0444
(651) 379-0434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300537
MN
1041C0700X
Clinical Social Worker
12613
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
539T6SP
BCBS ID#
MN
01
—
62-57490
MEDICA/UBH ID#
MN
01
—
HP42060
HEALTH PARTNERS
MN
Enumeration date
10/20/2005
Last updated
09/11/2025
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