Kathleen Diane Kongsjord, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4477 Issued in MN

Practice address

11600 State Ave
Brainerd, MN 56401-7306

Phone

(218) 454-8919

NPI assigned

Jul 8, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeview Behavioral Health IncGroup PAC ID 9537432307, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow on Purpose Counseling

  • Mental Health Counselor
  • Baxter, MN
  • NPI 1790666824
  Medicare reassignment NPD Authorized official
• Lakeview Behavioral Health Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1154404325
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1013753185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7038 REMINGTON WAY",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564016397",
            "telephone_number": "121-825-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 STATE AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564017306",
            "telephone_number": "218-454-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONGSJORD",
        "first_name": "KATHLEEN",
        "middle_name": "DIANE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KM Nutrition, LLC
• Tamara Kmecik, LICSW
• Loren Dale Kmett, AUDIOLOGIST
• Rodney Lamar Knowles, M.S.
• Jean Kocer, MSW, LICSW
• John Phillip Koop, PHARM. D.
• Jaclyn Ann Kostecka, PA-C
• Kayla Kral
• Julie Krall
• Kaila Marie Kramer, RDN

• Mental Health Counselor in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.