Individual provider Active NPI

Kimberly Lynn Diepenbrock, MA, LMFT

  • Marriage & Family Therapist
  • Bloomington, MN
National Provider Identifier
1144825514
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4023 Issued in MN
Practice address
1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone
(612) 331-9413
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4023 MN Primary

Addresses

Primary practice location

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230

Mailing address

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone (612) 331-9413

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250507002302 MN Practitioner - Marriage and Family Therapist 6305363920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4023MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Dec 1, 2020 Accepting new patients
Fraser PastSince Dec 1, 2020 Accepting new patients

Locations

6458 City West Pkwy
Eden Prairie, MN 55344
Phone (952) 767-5900

1801 American Blvd E
Ste 8
Minneapolis, MN 55425
Phone (612) 400-6173

Organizations & group practices 2

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1144825514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "612-331-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "612-331-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEPENBROCK",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.