Kailly Allyce Bonnett, MS LADC LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

01951 Issued in MN

Practice address

911 18TH St N
Saint Cloud, MN 56303-1203

Phone

(320) 650-1550

NPI assigned

Mar 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798

  MN

  Medicare reassignment NPD
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  NPD
• St. Cloud Hospital

  • Home Health Agency
  • Waite Park, MN
  • NPI 1952350605
  NPD
• Jacy II LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Litchfield, MN
  • NPI 1760929574
  NPD (past)

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1154852309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 17TH STREET CT",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563792754",
            "telephone_number": "218-349-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 18TH ST N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031203",
            "telephone_number": "320-650-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1326 E Ripley St",
            "address_purpose": "LOCATION",
            "city": "Litchfield",
            "state": "MN",
            "postal_code": "553554525",
            "country_code": "US",
            "telephone_number": "320-593-0440 x20",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNETT",
        "first_name": "KAILLY",
        "middle_name": "ALLYCE",
        "credential": "MS LADC LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01951",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laureen Kay Bollmeyer, PT
• Stephen Bologna
• Derek John Bonacci, O.D.
• Michael Bond, CRNA
• Olivia Lee Bond
• Cole Bonovsky
• Jodi Ann Boos, LADC
• Elisabeth Patricia Borash, LPN
• Annalicia Bordayo
• Alexandra R Borders, AUD

• All providers in Saint Cloud, MN
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.