Shannon Marie Kuball, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3706 Issued in MN

Practice address

1306 Marshall St
Saint Peter, MN 56082-4500

Phone

(507) 931-8040

NPI assigned

Aug 28, 2013

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Counseling Services of Southern Minnesota, Inc

  • Clinical Social Worker
  • Saint Peter, MN
  • NPI 1962557496

  Marriage & Family Therapist

  NPD
• Mankato Marriage and Family Therapy Center PLC

  • Mental Health Counselor
  • Mankato, MN
  • NPI 1689990665
  NPD (past)

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1275967119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22156 LAKE AVE",
            "city": "WATERVILLE",
            "state": "MN",
            "postal_code": "560969317",
            "telephone_number": "507-838-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 MARSHALL ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560824500",
            "telephone_number": "507-931-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Long St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560014397",
            "country_code": "US",
            "telephone_number": "507-625-4884",
            "fax_number": "507-625-6311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBALL",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond John Knutson, M.A., L.P.
• Tatiana Komleva, PSY.D., LP.
• Jenny A Kortuem, MS CCC-SLP
• John Howard Krohn
• Ashley Krug, ATC
• Carol Jean Kuisle, LICSW
• Amy A Kvidera, MD
• Michael Joseph Lange, M.S., L.P.
• Kevin James Langton, LADC
• Tara Lynn Lassen, APRN

• Marriage & Family Therapist in Saint Peter, MN
• Providers in Saint Peter, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.