Kelsey Ann Landis, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1742 Issued in MN

Practice address

325 33Rd Ave N Ste 103
Saint Cloud, MN 56303-1929

Phone

(320) 253-3715

Fax

(320) 252-2567

NPI assigned

Oct 28, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Kelsey Landis, Ms LMFT LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sartell, MN
  • NPI 1528572021

  MN

  Medicare reassignment NPD Authorized official
• Pamela Becker, Ma, LMFT LLC

  • Marriage & Family Therapist
  • Sartell, MN
  • NPI 1407360928
  NPD (past)
• Psychotherapeutic Resources LLP

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1619059755
  NPD (past)

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1104152032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 33RD AVE N STE 103",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031929",
            "telephone_number": "320-253-3715",
            "fax_number": "320-252-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 33RD AVE N STE 103",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031929",
            "telephone_number": "320-253-3715",
            "fax_number": "320-252-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273940100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madisen Lamp, OTR/L
• Brittany Pamela Lampher, FNP-C
• Jacob Kactus Lance
• Land of Lakes Transportation LLC
• Roxanne Landers, RN
• Makenzie Pearl Landsberger, RN
• Jessica Lynn Landucci, MS
• Brianna Renee Landwehr, MSW, LGSW
• Tania Landwehr, CMT
• Lyndsey Lanes, MSW, LICSW

• All providers in Saint Cloud, MN
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.