Individual provider Active NPI

Kalene Haugen, LMFT

  • Marriage & Family Therapist
  • New Brighton, MN
National Provider Identifier
1043709421
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3764 Issued in MN
Practice address
1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone
(651) 628-9566
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2018-060 ND
Marriage & Family Therapist 106H00000X 3764 MN Primary

Addresses

Primary practice location

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Other names 1

  • Kalene Ann Sharstrom Former name

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
I20240114000018 MN Practitioner - Marriage and Family Therapist 3779935895 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018-060NDMDMarriage & Family Therapist
3764MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1043709421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "KALENE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ND",
            "license": "2018-060",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALENE",
            "last_name": "SHARSTROM",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.