Individual provider Active NPI

Denae R Kuenzel, PSYD, LP

  • Counseling Psychologist
  • Elk River, MN
National Provider Identifier
1033446331
Registry record updated Jul 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP6407 Issued in MN
Practice address
253 8TH St NW Ste a
Elk River, MN 55330-1581
Phone
(763) 441-3770
Fax
(763) 441-9057
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2866 MN
Counseling Psychologist 103TC1900X LP6407 MN Primary

Addresses

Primary practice location

253 8TH St NW Ste a
Elk River, MN 55330-1581

Mailing address

21308 John Milless Dr Ste 206
Rogers, MN 55374-4870
Phone (637) 445-9758

Other practice location 1

701 25th Ave S
Suite 200
Minneapolis, MN 55454-1513
Phone (612) 339-2836

Other practice location 2

21308 John Milless Dr Ste 206
Rogers, MN 55374
Phone (763) 445-9758

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200227002723 MN Practitioner - Clinical Psychologist 2860520129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21308 John Milless Dr
Suite 206
Rogers, MN 55374-4870
Phone (763) 445-9758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP6407MNMDCounseling Psychologist
2866MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Regroup Counseling and Consulting PSC CurrentSince Jun 10, 2021 Accepting new patients
Monarch Counseling Collaborative PA CurrentSince Aug 1, 2024 Accepting new patients
Central Minnesota Mental Health Center PastSince Jan 19, 2020 Accepting new patients

Locations

18336 Joplin St NW
Elk River, MN 55330
Phone (763) 350-9687

586 Dodge Ave NW
Ste B
Elk River, MN 55330
Phone (763) 350-9687

21308 John Milless Dr
Ste 206
Rogers, MN 55374
Phone (763) 445-9758

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1033446331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21308 JOHN MILLESS DR STE 206",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744870",
            "telephone_number": "637-445-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 8TH ST NW STE A",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301581",
            "telephone_number": "763-441-3770",
            "fax_number": "763-441-9057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 25th Ave S",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541513",
            "country_code": "US",
            "telephone_number": "612-339-2836",
            "fax_number": "612-339-9741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21308 John Milless Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "MN",
            "postal_code": "55374",
            "country_code": "US",
            "telephone_number": "763-445-9758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUENZEL",
        "first_name": "DENAE",
        "middle_name": "R",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2866",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP6407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.