Kaila Park, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

01887 Issued in MN

Practice address

3033 Excelsior Blvd Ste 215
Minneapolis, MN 55416-5274

Phone

(651) 456-8396

NPI assigned

Nov 21, 2017

Last updated

Oct 30, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1114431558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 LONGACRES DR",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553177557",
            "telephone_number": "763-458-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 215",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165274",
            "telephone_number": "651-456-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KAILA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "01887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Place Unity Clinic LLC
• Byoung Uk Park, MD
• Glennon Kyusun Park, M.D.
• Jeong Eun Park, LMFT
• June Park, PA-C
• Katharine Sippel Park, MD
• Meeock Park, PH. D.
• Michael Chankwon Park, M.D., PH.D.
• Paul Park
• Shannon Park

• Professional Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.