NPIMap

Organization Active NPI

Minnesota State Colleges and Universities

Doing business as Minnesota State University, Mankato

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mankato, MN
National Provider Identifier
1104651355
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Doing business as
Minnesota State University, Mankato
Practice address
1600 Warren St Ste 6
Mankato, MN 56001-7113
Phone
(507) 389-1443
NPI assigned
Sep 6, 2024
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MINNESOTA STATE COLLEGES AND UNIVERSITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Roy Kammer
Title
Dean
Phone
(507) 389-1546

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

1600 Warren St Ste 6
Mankato, MN 56001-7113

Mailing address

1600 Warren St Ste 6
Mankato, MN 56001-7113
Phone (507) 389-1443

Other names 2

  • Minnesota State University, Mankato Doing business as
  • Rural Behavioral Health Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140121000489 MN Part B Supplier - Clinic/Group Practice 2264334663 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mankato, MN; Moorhead, MN

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Minnesota State Colleges Universities27 organizations share this tax ID, including this one
Part of
Minnesota State Colleges Universities

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1104651355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WARREN ST STE 6",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017113",
            "telephone_number": "507-389-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WARREN ST STE 6",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017113",
            "telephone_number": "507-389-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA STATE COLLEGES AND UNIVERSITIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNESOTA STATE COLLEGES AND UNIVERSITIES",
        "enumeration_date": "2024-09-06",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "KAMMER",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "DEAN",
        "authorized_official_telephone_number": "507-389-1546"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnesota State University, Mankato",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rural Behavioral Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.