Active NPI
Marla Catherine Kennedy, MA LP LMFT
- Counseling Psychologist
- Minneapolis, MN
National Provider Identifier
1023238904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP 1248
- Practice address
- 4103 East Lake St.
Minneapolis, MN 55406-2259 - Phone
- (651) 645-6020
- Fax
- (651) 645-6020
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP 1248 | MN | Primary |
| Marriage & Family Therapist | 106H00000X | 0666 | MN |
Addresses
Primary practice location
4103 East Lake St.
Minneapolis, MN 55406-2259
Mailing address
2259 Summit Ave.
Saint Paul, MN 55105-1002
Phone (651) 645-3303
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP36121 | Other | MN | HEALTH PARTNERS OLD |
| 0666 | Other | MN | MARRIAGE AND FAMILY LICEN |
| 72325277000 | Medicaid | MN | |
| LP1248 | Other | MN | PSYCHOLOGY LICENSE |
| BC 1GO74KE | Other | MN | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 1248 | MN | MD | Counseling Psychologist |
| 0666 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1023238904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2259 SUMMIT AVE.",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551051002",
"telephone_number": "651-645-3303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4103 EAST LAKE ST.",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554062259",
"telephone_number": "651-645-6020",
"fax_number": "651-645-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MARLA",
"middle_name": "CATHERINE",
"name_prefix": "Mrs.",
"credential": "MA LP LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP 1248",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "0666",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS OLD",
"identifier": "HP36121",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARRIAGE AND FAMILY LICEN",
"identifier": "0666",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "72325277000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY LICENSE",
"identifier": "LP1248",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "BC 1GO74KE",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.