Vencil, Kellan

Vencil, Kellan is an individual health care provider with primary practice located at 1875 Station Pkwy Nw , Andover MN 55304-3319. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Vencil, Kellan can be contacted via phone (763) 482-9598.

Contact Information

Primary practice address
1875 Station Pkwy Nw Andover MN 55304-3319
Phone: (763) 482-9598
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X P-1400 Nebraska
Behavioral Health & Social Service Providers / Professional 101YP2500X CC02700 Minnesota

Profile Details

NPI number 1083143655
LBN Legal business name Vencil, Kellan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2017
Last updated Jul 15th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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