Kimberley Zack, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2096 Issued in MN

Practice address

2525 Chicago Ave
Minneapolis, MN 55404-4518

Phone

(612) 813-6007

NPI assigned

Sep 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberley Singh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lee Carlson Center for Mental Health and Well-Being

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
  • NPI 1457455057
  NPD (past)

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1144870981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 STRYKER AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACK",
        "first_name": "KIMBERLEY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLEY",
            "last_name": "SINGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Zachman
• Anne Zachman
• Kaitlyn Zachman
• Tiffany Ann Zachman, RN
• Zachary John Zachman, D.C.
• Laura Ann Zaczkowski Moorhead
• Mark Zaczkowski Moorhead, MSW, LICSW
• Rebecca J Zadroga, MD
• Jawad Zafar, M.D.
• Maliha Zafari, MD

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.