Provider Demographics
NPI:1629574900
Name:KLEVE, KALEE MARIE (MA, LPCC)
Entity type:Individual
Prefix:
First Name:KALEE
Middle Name:MARIE
Last Name:KLEVE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:KALEE
Other - Middle Name:MARIE
Other - Last Name:PETRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1714 BUNKER LAKE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-4017
Mailing Address - Country:US
Mailing Address - Phone:763-330-2830
Mailing Address - Fax:763-330-2831
Practice Address - Street 1:1714 BUNKER LAKE BLVD NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-4017
Practice Address - Country:US
Practice Address - Phone:763-330-2830
Practice Address - Fax:763-330-3831
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC04409101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional