Individual provider Active NPI

Katherine Lynn Hardy-Roth, LPCC

  • Professional Counselor
  • Elk River, MN
National Provider Identifier
1215701487
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC04093 Issued in MN
Practice address
11070 183Rd Cir NW Ste C
Elk River, MN 55330-3701
Phone
(763) 633-5111
NPI assigned
Nov 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC04093 MN Primary

Addresses

Primary practice location

11070 183Rd Cir NW Ste C
Elk River, MN 55330-3701

Mailing address

11070 183Rd Cir NW Ste C
Elk River, MN 55330-3701
Phone (763) 633-5111

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
I20231227003144 MN Practitioner - Mental Health Counselor 0143670554 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CC04093MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hardy & Stephens Counseling Associates PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

11070 183rd Cir NW
Ste C
Elk River, MN 55330
Phone (763) 257-5301

Organizations & group practices 1

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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1215701487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW STE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303701",
            "telephone_number": "763-633-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW STE C",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303701",
            "telephone_number": "763-633-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY-ROTH",
        "first_name": "KATHERINE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

Verify at the official NPI Registry.