MR. KEITH LESLIE DERAAD (NPI# 1063532216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063532216 |
| Entity Type | Individual |
| Full Name | MR. KEITH LESLIE DERAAD |
| Credential | CPRP |
| Practice Address |
1825 Chicago Ave Minneapolis MN 55404-1939 |
| Mailing Address |
3700 W 83rd St Bloomington MN 55431-1063 |
| Practice Telephone | 6127528246 |
| Practice Fax Number | 6127528203 |
| Mailing Telephone | 9528428273 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1825 CHICAGO AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-1939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851446280 | Resource, Inc. | Case Management | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2007-01-24 |
| 1750904439 | Nicole Anne Mukanda | Social Worker | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2020-05-28 |
| 1982237566 | Danyell Shawntell Easter | Social Worker | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2020-02-21 |
| 1477900140 | Carrie L Johnson | Social Worker | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2016-05-23 |
| 1841589272 | Emily Ann Bastian | Social Worker | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2011-04-06 |
| 1851546972 | Susan Kay Kennelly | Social Worker | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2008-11-18 |
| 1982875571 | Resource, Inc. | Case Management | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2008-03-21 |
| 1942321815 | Karen D Hovland | Social Worker | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2007-04-02 |
| 1275654915 | Charlie Lentz | Counselor | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2007-04-02 |
| 1447305784 | Resource, Inc. | Case Management | 1825 Chicago Ave, Minneapolis, MN 55404-1939 | 2007-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949432 | Ives Kenneth Wittman | Counselor | 1828 Jefferson St Ne, Minneapolis, MN 55418-4427 | 2020-10-12 |
| 1194331397 | Link Psychotherapy Ltd | Counselor | 4749 Chicago Ave # Ic, Minneapolis, MN 55407-3556 | 2020-09-22 |
| 1538775143 | Elise Nathalie Meger | Counselor | 3033 Excelsior Blvd Ste 215, Minneapolis, MN 55416-5274 | 2020-09-18 |
| 1508472341 | Healing Path Center, LLC | Counselor | 2203 James Ave N, Minneapolis, MN 55411-1930 | 2020-09-17 |
| 1386258143 | Breakthrough Therapy Center, LLC | Counselor | 2833 13th Ave S Ste 216, Minneapolis, MN 55407-1417 | 2020-08-31 |
| 1740893957 | Amzie Elizabeth Reeves | Counselor | 2010 E Hennepin Ave Ste 2-110, Minneapolis, MN 55413-2760 | 2020-08-26 |
| 1548870512 | Community Solutions Services Inc | Counselor | 3043 2nd Ave South, Suite 101, Minneapolis, MN 55408 | 2020-08-05 |
| 1063020931 | Grandpa & Grandma Adult Day Care, Inc. | Counselor | 2518 N 2nd St Ste 116, Minneapolis, MN 55411-2259 | 2020-07-16 |
| 1932724812 | Demi Rose Mancini | Counselor | 900 S 8th St Bldg 4th, Minneapolis, MN 55404-1292 | 2020-06-16 |
| 1891322277 | Susan Marie Daub | Counselor | 1330 Lagoon Ave Fl 4, Minneapolis, MN 55408-2885 | 2020-03-25 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55404 |
Please comment or provide details below to improve the information on MR. KEITH LESLIE DERAAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.