Kelly Ann Evertz, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4397 Issued in MN

Practice address

404 W Superior St Ste 210
Duluth, MN 55802-1569

Phone

(218) 606-1100

NPI assigned

Nov 7, 2022

Last updated

Nov 17, 2023By the provider in NPPES

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

Electronic endpoints 1

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

Marriage and Family Therapist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Two Rivers Counseling LLCGroup PAC ID 7416322268, 17 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Two Rivers Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1093486722
  Medicare reassignment Care Compare group NPD
• Duluth Counseling Center

  • Community/Behavioral Health Agency
  • Duluth, MN
  • NPI 1679815823
  NPD

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1033827233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BANKS BLVD",
            "city": "SILVER BAY",
            "state": "MN",
            "postal_code": "556141339",
            "telephone_number": "320-424-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W SUPERIOR ST STE 210",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021569",
            "telephone_number": "218-606-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERTZ",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.duluthcounselingcenter.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "11 E Superior St Ste 415",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558023008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy Cogswell Evans, MD
• Jeffrey A. Evanson, MD
• Austin Evenson
• Eric Alan Evenson
• Jennifer Paige Everett, LPCC
• Matthew Evingson, PA-C
• Nolan J Ewert, LPCC
• Eyemart Express LLC
• Eyemart Express, LTD.
• Steven Duane Eyer

• Marriage & Family Therapist in Duluth, MN
• Providers in Duluth, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.