Melissa Ann Bollinger-Kinney, M.S.ED LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

226 Issued in MN

Practice address

3021 Harbor LN N Ste 206
Plymouth, MN 55447-5120

Phone

(763) 559-1640

Fax

(763) 559-1617

NPI assigned

Jan 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

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.

• The Minnesota Ketamine and Wellness Institute PA

  • Anesthesiology Physician
  • Maple Grove, MN
  • NPI 1003408857

  Multi-Specialty

  NPD
• Plymouth Psych Group, LLC

  • Mental Health Counselor
  • Plymouth, MN
  • NPI 1003195942
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1114074028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6369 POLARIS LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113938",
            "telephone_number": "612-508-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 HARBOR LN N STE 206",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475120",
            "telephone_number": "763-559-1640",
            "fax_number": "763-559-1617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 81st Ave NE",
            "address_purpose": "LOCATION",
            "city": "Spring Lake Park",
            "state": "MN",
            "postal_code": "554322111",
            "country_code": "US",
            "telephone_number": "763-780-3036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLINGER-KINNEY",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.S.ED LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Hurd Bodiker, MS, CCC-SLP
• Paul D Boettner, D.D.S.
• Trayvaughn Bogard-Merrick
• Chad E Boger, D.D.S.
• Kristina Ann Bohm, FNP
• Helaine Bolter, PSY.D, LP
• Tom Bomberg, D.C.
• Marla Bookhout, PT
• Emma Kathleen Boone, PA
• Megan Ann Borelli

• Mental Health Counselor in Plymouth, MN
• Providers in Plymouth, 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 Oct 25, 2018; 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.