Marit Kyllo, L.A.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3071 Issued in MN

Practice address

1619 Dayton Ave
Suite 303
Saint Paul, MN 55104-6206

Phone

(651) 605-6050

NPI assigned

Sep 17, 2015

Last updated

Sep 17, 2015By the provider in NPPES

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

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

Specialty

Marriage and Family Therapist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Fernbrook Family Center IncGroup PAC ID 3870872914, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fernbrook Family Center, Inc

  • Social Worker
  • Owatonna, MN
  • NPI 1659483915
  Medicare reassignment Care Compare group NPD
• Centered Practice

  • Community/Behavioral Health Agency
  • Northfield, MN
  • NPI 1235428665
  NPD (past)
• Fernbrook Family Center

  • Social Worker
  • Red Wing, MN
  • NPI 1437427911
  NPD (past)
• Fernbrook Family Center, Inc

  • Case Management Agency
  • Faribault, MN
  • NPI 1083537781
  NPD (past)

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1174992457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE",
            "address_2": "SUITE 303",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046206",
            "telephone_number": "651-605-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE",
            "address_2": "SUITE 303",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046206",
            "telephone_number": "651-605-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLLO",
        "first_name": "MARIT",
        "credential": "L.A.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaun W Kwosek, MD
• Allan Kyariga
• Kathryn A Kyler, CRNA
• Natalie Kyllo-Peters, PT
• Jennifer H Kyllo, MD
• La Familia Guidance Center
• Vanesa Concepcion La Torre Martinez
• Lab Drugs & Medical-Trans-Supplies LLC (Polar Pharmacy & Medical Supplies)
• Thomas Laberge, MD
• Laboratory Corporation of America Holdings

• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.