Provider Demographics
NPI:1730357443
Name:KERNO, CHRISTINE M (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:KERNO
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 HENNEPIN AVE STE 210A
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3413
Mailing Address - Country:US
Mailing Address - Phone:612-214-0447
Mailing Address - Fax:
Practice Address - Street 1:3249 HENNEPIN AVE STE 210A
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-3413
Practice Address - Country:US
Practice Address - Phone:612-214-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2019-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN136281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical