Individual provider Active NPI

Katelyn Sofia Yliniemi, LPCC

  • Mental Health Counselor
  • Fargo, ND
National Provider Identifier
1124736228
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1213-7-1-22-603 Issued in ND
Practice address
5354 42ND St S Ste B
Fargo, ND 58104-4032
Phone
(701) 501-8014
Fax
(701) 941-4504
NPI assigned
Nov 8, 2022
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1213-7-1-22A ND
Mental Health Counselor 101YM0800X 1213-7-1-22-603 ND Primary

Addresses

Primary practice location

5354 42ND St S Ste B
Fargo, ND 58104-4032

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241024000556 ND Practitioner - Mental Health Counselor 9537692975 Reassigns benefits to 1 organization
I20260623002636 MN Practitioner - Mental Health Counselor 9537692975

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5354 42ND St S
Suite B
Fargo, ND 58104-4032
Phone (701) 941-4503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Oct 1, 2024 Accepting new patients
Nystrom & Associates, LTD CurrentSince Dec 1, 2022 Accepting new patients
Family Support Services Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2405 8th St S
Ste 200
Moorhead, MN 56560
Phone (218) 331-4866

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

5354 42nd St S
Ste B
Fargo, ND 58104
Phone (701) 501-8014

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1124736228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 42ND ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044032",
            "telephone_number": "701-501-8014",
            "fax_number": "701-941-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YLINIEMI",
        "first_name": "KATELYN",
        "middle_name": "SOFIA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "1213-7-1-22A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "1213-7-1-22-603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.