Individual provider Active NPI

Robert Kistler, LMFT

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1083044739
Registry record updated Nov 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2199 Issued in MN
Practice address
1806 Ivy Ave E
Saint Paul, MN 55119-4522
Phone
(612) 978-3030
NPI assigned
Nov 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2199 MN Primary

Addresses

Primary practice location

1806 Ivy Ave E
Saint Paul, MN 55119-4522

Mailing address

1806 Ivy Ave E
Saint Paul, MN 55119-4522
Phone (612) 978-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Counseling Services, LLC Marriage & Family Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384560000000",
    "number": "1083044739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 IVY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194522",
            "telephone_number": "612-978-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 IVY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194522",
            "telephone_number": "612-978-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "ROBERT",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-16",
        "last_updated": "2013-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.