Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Marie Kruckeberg, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1952478588

Kelly Marie Kruckeberg, MS, CCC-SLP is a Speech-Language Pathologist in St Louis Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone: (952) 993-1029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 7955 (MN)

Record details

NPI number1952478588
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedNovember 29, 2006
Last updated in NPPESApril 7, 2016

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