Kiley Ellingson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

02114 Issued in MN

Practice address

44 Good Counsel Dr
Mankato, MN 56001-6599

Phone

(800) 438-1772

Fax

(262) 345-5562

NPI assigned

Feb 12, 2018

Last updated

Oct 8, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 10, 2024 through Jun 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wisconsin Lutheran Child & Family Service, Inc

  dba Christian Family Counseling

  • Clinical Psychologist
  • Mankato, MN
  • NPI 1669758520

  Professional

  NPD (past)
• The Journey Center for Healing Arts, PLLC

  • Mental Health Counselor
  • Johnson City, TN
  • NPI 1013434828
  NPD (past)
• Wisconsin Lutheran Child and Family Service Inc

  dba Christian Family Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, WI
  • NPI 1083786628

  Professional

  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1275032682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226511",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 GOOD COUNSEL DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016599",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSON",
        "first_name": "KILEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Eischen
• Ashley Mary Kay Eisenmenger
• Isaac Eissinger
• Jane Joanne Ek, LPCC
• Mohamad El Labban
• Brian Jon Ellingworth, PT
• Emily Ellingworth, CRNA
• Morgan Elizabeth Ellis
• Holly Sue Ellison, RD, LD
• Jennifer Anne Ellsworth, LICSW

• Professional Counselor in Mankato, MN
• Providers in Mankato, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.