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Individual

KEITH CLEPPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW, LADC

Contact information

Practice address
550 OSBORNE RD NE, FRIDLEY, MN 55432
(763) 236-4635
(763) 236-4370
Mailing address
550 OSBORNE RD. NE, MR 53450, FRIDLEY, MN 55432
(763) 236-4635
(763) 236-4370

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302390
MN
1041C0700X
Clinical Social Worker
Primary
21855
MN

Other

Enumeration date
06/21/2016
Last updated
06/21/2016
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