Active NPI
Kathryn Naomi Hall, L.P.
- Counseling Psychologist
- Maplewood, MN
National Provider Identifier
1114091709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP3782
- Practice address
- 2115 County Road D E
Suite B
Maplewood, MN 55109-5353 - Phone
- (651) 748-5019
- Fax
- (651) 773-7591
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP3782 | MN | Primary |
Addresses
Primary practice location
2115 County Road D E
Suite B
Maplewood, MN 55109-5353
Mailing address
2115 County Road D E
Suite B
Maplewood, MN 55109-5353
Phone (651) 748-5019
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036316200 | Medicaid | MN | |
| 375G3HA | Other | MN | BLUE CROSS BLUE SHIELD |
| HP45668 | Other | MN | HEALTH PARTNERS |
| 6267153 | Other | MN | UBH AND MEDICA |
| 111201 | Other | MN | BHP AND UCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3782 | MN | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Life Counseling Center, PLLC | 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.
-
- Clinical Psychologist
- Lake Elmo, MN
- NPI 1649644634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1114091709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 COUNTY ROAD D E",
"address_2": "SUITE B",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551095353",
"telephone_number": "651-748-5019",
"fax_number": "651-773-7591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 COUNTY ROAD D E",
"address_2": "SUITE B",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551095353",
"telephone_number": "651-748-5019",
"fax_number": "651-773-7591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "KATHRYN",
"middle_name": "NAOMI",
"name_prefix": "Ms.",
"credential": "L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP3782",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036316200",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "375G3HA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP45668",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH AND MEDICA",
"identifier": "6267153",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BHP AND UCARE",
"identifier": "111201",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.