Stacy Marie Kriese, LADC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

703 Thielen Dr
Saint Michael, MN 55376-9613

Phone

(763) 515-4563

NPI assigned

Apr 3, 2012

Sex

Female

Sole proprietor

Yes

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

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.

• Attacure, LLC

  • Marriage & Family Therapist
  • Saint Cloud, MN
  • NPI 1104359157

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1245596352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6377 85TH ST NE",
            "city": "FOLEY",
            "state": "MN",
            "postal_code": "563299540",
            "telephone_number": "320-266-3819",
            "fax_number": "763-389-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 THIELEN DR",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769613",
            "telephone_number": "763-515-4563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1506 1st St",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "MN",
            "postal_code": "553711462",
            "country_code": "US",
            "telephone_number": "763-389-5080 x120",
            "fax_number": "763-389-5453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRIESE",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LADC, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302909",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Kerkula
• Ariel Kimbrough, LMFT
• Grace Catherine Klingsporn
• Brita M Koivisto, PA-C
• Marissa Kovensky, MSW, LGSW
• Christina Marie Kurtz
• Victoria Ann Kyarsgaard
• Kimberly Lamine
• Mary Lange, LICSW
• Maurita Sue Lehman

• All providers in Saint Michael, MN
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.