Individual provider Active NPI

Kristin Blegen

  • Mental Health Counselor
  • Apple Valley, MN
National Provider Identifier
1184210197
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC01828 Issued in MN
Practice address
7300 147TH St W Ste 204
Apple Valley, MN 55124-7850
Phone
(952) 997-3020
Fax
(952) 997-3026
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC01828 MN Primary

Addresses

Primary practice location

7300 147TH St W Ste 204
Apple Valley, MN 55124-7850

Mailing address

4887 149TH CT
Apple Valley, MN 55124-4216
Phone (651) 242-9560

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
I20240208001477 MN Practitioner - Mental Health Counselor 8820431679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

7300 147TH St W
Suite 600
Apple Valley, MN 55124-7850
Phone (952) 997-3020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC01828MNMDMental Health Counselor
1828MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Jan 1, 2024 Accepting new patients
Family Support Services Inc. Mental Health PastSince Jan 1, 2024 Accepting new patients

Locations

7300 147th St W
Ste 600
Apple Valley, MN 55124
Phone (952) 997-3020

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1184210197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887 149TH CT",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244216",
            "telephone_number": "651-242-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 147TH ST W STE 204",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247850",
            "telephone_number": "952-997-3020",
            "fax_number": "952-997-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEGEN",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.