Katelin Nicole Varnson, DNP, PMHNP-BC

Key facts

NPI: 1235669490
Entity type: Individual (NPI type 1)
Primary specialty: Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License: 5181 (MN)
Practice address: 149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238
Phone: (651) 450-0860
Fax: (651) 450-0759
NPI assigned: Jun 19, 2017
Sex: Female
Sole proprietor: No

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.

Associated Clinic of Psychology Inc Mental Health Clinic/Center (Including Community Mental Health Center) · St Louis Park, MN · NPI 1588741292

Medicare reassignment Care Compare group NPD MN

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2019
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Associated Clinic of Psychology Inc (136 clinicians)

Practice addresses (Care Compare)

149 Thompson Ave E
Suite 150
West St Paul, MN 55118-3238
Phone (651) 450-0860

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MN
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20170815004601	MN	Practitioner - Nurse Practitioner	5294007928	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
5181	MN	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Associated Clinic of Psychology Inc		Current since Apr 9, 2021	Accepting new patients

Locations

4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033

4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033

149 Thompson Ave E
Ste 150
West St Paul, MN 55118
Phone (651) 450-0860

2501 Hanley Rd
Ste 101
Hudson, WI 54016
Phone (715) 954-5300

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	5181	MN	Yes

Addresses

Primary practice location

149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

Other practice location 1

2501 Hanley Rd Ste 101
Hudson, WI 54016-8786
Phone (715) 954-5300

Other names

Katelin Umland Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 2, 2021.

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1235669490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 THOMPSON AVE E STE 150",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183238",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Hanley Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540168786",
            "country_code": "US",
            "telephone_number": "715-954-5300",
            "fax_number": "715-954-5301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARNSON",
        "first_name": "KATELIN",
        "middle_name": "NICOLE",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "5181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELIN",
            "last_name": "UMLAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West St Paul, MN

All providers in West St Paul, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.