Jessica Kay Kisling, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC00337 Issued in MN

Practice address

12601 Ridgedale Dr
Social Service Center, Level 2
Minnetonka, MN 55305-1911

Phone

(612) 348-7379

NPI assigned

Jul 5, 2011

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

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

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Canvas Health IncGroup PAC ID 8729073978, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jessica.kisling.p3@direct.ramseysocialservices.nextgenshare.com

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.

• Canvas Health, Inc.

  • Mental Health Counselor
  • Oakdale, MN
  • NPI 1922051325
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1073800637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 BERNARD AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293625",
            "telephone_number": "612-701-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12601 RIDGEDALE DR",
            "address_2": "SOCIAL SERVICE CENTER, LEVEL 2",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051911",
            "telephone_number": "612-348-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLING",
        "first_name": "JESSICA",
        "middle_name": "KAY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan King, APRN
• Warren King, L.AC.
• Surabhi Kiran
• Cody James Kirk
• Ryan Kirkland
• Susan Lee Kissell, RN, CNP
• Gregory H Kjos, CRNA
• Janis Kristin Klecker, DDS
• Angela Diane Kleinedler, MA CCC-SLP
• Jennifer Kleinhans, LPCC

• Mental Health Counselor in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.