Individual provider Active NPI

Kaitlyn Conroy, LPC, QMHP, NCC

  • Mental Health Counselor
  • Yankton, SD
National Provider Identifier
1063162980
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC20807 Issued in SD
Practice address
1028 Walnut St
Yankton, SD 57078-2910
Phone
(605) 665-4606
NPI assigned
Mar 24, 2022
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC20807 SD Primary

Addresses

Primary practice location

1028 Walnut St
Yankton, SD 57078-2910

Mailing address

614 Broadway Ave
Yankton, SD 57078-3516
Phone (605) 665-0841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20240410004000 SD Practitioner - Mental Health Counselor 4789022633 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Psychological Services Mental Health CurrentSince May 1, 2024 Accepting new patients
Lewis & Clark Behavioral Health Services, Inc. Counselor PastSince Mar 27, 2022 Accepting new patients
Lewis & Clark Mental Health Center Mental Health PastSince Mar 27, 2022 Accepting new patients

Locations

116 Market St
Vermillion, SD 57069
Phone (605) 665-0841

614 Broadway Ave
Yankton, SD 57078
Phone (605) 661-0841

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, 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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1063162980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570783516",
            "telephone_number": "605-665-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 WALNUT ST",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570782910",
            "telephone_number": "605-665-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "KAITLYN",
        "credential": "LPC, QMHP, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC20807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.