Reverie Mental Health PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REVERIE MENTAL HEALTH PLLC

Practice address

32 10TH Ave S Ste 206
Hopkins, MN 55343-9481

Phone

(612) 405-0414

Fax

(571) 376-6561

NPI assigned

Sep 13, 2022

Organization subpart

No

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

Authorized official

Name

Mackenzie Kampa, APRNNPI 1912400797

Title

Owner

Phone

(612) 405-0414

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mackenzie Kampa, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneapolis, MN
  • NPI 1912400797
  NPD Authorized official

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1063134567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 10TH AVE S STE 206",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553439481",
            "telephone_number": "612-405-0414",
            "fax_number": "571-376-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 10TH AVE S STE 206",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553439481",
            "telephone_number": "612-405-0414",
            "fax_number": "571-376-6561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14996 Williamsburg Ct",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553471524",
            "country_code": "US",
            "telephone_number": "612-405-0414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVERIE MENTAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "KAMPA",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-405-0414",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Elizabeth Rangel, LICSW
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• Reliacare Medical Supply, LLC
• Kathy Reznikova
• Ann Elizabeth Rice, CNM
• Sydney Leigh Richardson, PT
• Emily Ann Riordan, M.S.,CCC-SLP
• Lisa Rivers, MA, LP

• Clinic/Center in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.