IndividualActive
Kent Kodalen, PH.D.
NPI 1881006880 · Clinical Child & Adolescent Psychologist · Minneapolis, MN
Provider details
- NPI number
- 1881006880
- Entity type
- Individual
- Primary specialty
- Clinical Child & Adolescent PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5742 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2525 Chicago Ave
Mail Stop 17-217
Minneapolis, MN 55404-4518
Phone: (612) 813-7042
Approximate (ZIP-level) locationGet directions
Mailing address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Registry dates
- Enumerated
- 2014-05-24
- Last updated
- 2014-05-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.