Individual provider Active NPI

Kathryn Labore

  • Psychologist
  • Stillwater, MN
National Provider Identifier
1124982525
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP7086 Issued in MN
Practice address
333 Main St N Ste 110
Stillwater, MN 55082-5054
Phone
(651) 425-9297
NPI assigned
Dec 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP7086 MN Primary

Addresses

Primary practice location

333 Main St N Ste 110
Stillwater, MN 55082-5054

Mailing address

333 Main St N Ste 110
Stillwater, MN 55082-5054
Phone (651) 425-9297

Other names 1

  • Kathryn Bradshaw Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP7086MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nest Professional Service Corp CurrentSince Dec 14, 2025 Accepting new patients

Locations

333 Main St N
Ste 110
Stillwater, MN 55082
Phone (651) 300-4311

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.

NPI Registry JSON

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

{
    "created_epoch": "1765411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1124982525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MAIN ST N STE 110",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825054",
            "telephone_number": "651-425-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MAIN ST N STE 110",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825054",
            "telephone_number": "651-425-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABORE",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP7086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "BRADSHAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.