Basic Information
Provider Information
NPI: 1902201312
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARAN
FirstName: DAVID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6600 FRANCE AVE S
Address2: SUITE 230
City: EDINA
State: MN
PostalCode: 554351805
CountryCode: US
TelephoneNumber: 9528352002
FaxNumber: 9528359889
Practice Location
Address1: 6600 FRANCE AVE S
Address2: SUITE 230
City: EDINA
State: MN
PostalCode: 554351805
CountryCode: US
TelephoneNumber: 9528352002
FaxNumber: 9528359889
Other Information
ProviderEnumerationDate: 10/28/2014
LastUpdateDate: 10/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XCC00849MNY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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