Kirsten M Tchida, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2717 Issued in MN

Practice address

211 Holmes St W Ste 302
Detroit Lakes, MN 56501-9905

Phone

(218) 847-0629

Fax

(218) 846-1285

NPI assigned

Jan 11, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lutheran Social Service of Minnesota

  • Community/Behavioral Health Agency
  • Saint Cloud, MN
  • NPI 1629192430
  NPD

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1245829720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 HOLMES ST W STE 302",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565019905",
            "telephone_number": "218-847-0629",
            "fax_number": "218-846-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 HOLMES ST W STE 302",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565019905",
            "telephone_number": "218-847-0629",
            "fax_number": "218-846-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCHIDA",
        "first_name": "KIRSTEN",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSING BOARD",
            "identifier": "2717",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kirsten.tchida@lssmn.org",
            "affiliation": "N",
            "address_1": "211 Holmes St W Ste 302",
            "city": "Detroit Lakes",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565019905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.