Individual provider Active NPI

Kimberly Jean Dejno, LMFT, LADC

  • Marriage & Family Therapist
  • Rochester, MN
National Provider Identifier
1265948186
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3329 Issued in MN
Practice address
3257 19TH St NW Ste 4
Rochester, MN 55901-6797
Phone
(651) 955-4633
Fax
(651) 440-9827
NPI assigned
Dec 15, 2017
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303922 MN
Marriage & Family Therapist 106H00000X 3329 MN Primary

Addresses

Primary practice location

3257 19TH St NW Ste 4
Rochester, MN 55901-6797

Mailing address

9298 Central Ave NE Ste 310
Blaine, MN 55434-4219
Phone (651) 955-4633

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
I20240926004583 MN Practitioner - Marriage and Family Therapist 0941731269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Mental Health IncGroup PAC ID 1557804390, 16 clinicians

Practice addresses (Care Compare)

245 Ruth St N
Suite 101
Saint Paul, MN 55119-4409
Phone (651) 955-4633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303922MNMDAddiction (Substance Use Disorder) Counselor
3329MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Mental Health Inc Addiction (Substance Use Disorder) CurrentSince Aug 20, 2024 Accepting new patients

Locations

9298 Central Ave NE
Ste 310
Minneapolis, MN 55434
Phone (651) 955-4633

3257 19th St NW
Ste 4
Rochester, MN 55901
Phone (651) 955-4633

245 Ruth St N
Ste 101
Saint Paul, MN 55119
Phone (651) 955-4633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1265948186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9298 CENTRAL AVE NE STE 310",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344219",
            "telephone_number": "651-955-4633",
            "fax_number": "651-440-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 19TH ST NW STE 4",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016797",
            "telephone_number": "651-955-4633",
            "fax_number": "651-440-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJNO",
        "first_name": "KIMBERLY",
        "middle_name": "JEAN",
        "credential": "LMFT, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303922",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.