Individual provider Active NPI

Kahlynn Marie Loose, MA, LPCC

  • Professional Counselor
  • Saint Peter, MN
National Provider Identifier
1326518689
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC01972 Issued in MN
Practice address
1306 Marshall St
Saint Peter, MN 56082-4500
Phone
(507) 931-8040
Fax
(507) 931-8060
NPI assigned
Nov 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01972 MN Primary

Addresses

Primary practice location

1306 Marshall St
Saint Peter, MN 56082-4500

Mailing address

1306 Marshall St
Saint Peter, MN 56082-4500
Phone (507) 931-8040

Other identifiers 1

IdentifierTypeStateIssuer
CC01972OtherMNLPCC

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
I20240116003959 MN Practitioner - Mental Health Counselor 7911359823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Counseling Services of Southern Minnesota, IncGroup PAC ID 5890696868, 9 clinicians

Practice addresses (Care Compare)

1306 Marshall St
Saint Peter, MN 56082-4500
Phone (507) 931-8040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC01972MNMDProfessional Counselor
1972MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services of Southern Minnesota, Inc CurrentSince Jan 2, 2024 Accepting new patients

Locations

226 N Broad St
Mankato, MN 56001
Phone (507) 931-8040

1306 Marshall St
Saint Peter, MN 56082
Phone (507) 931-8040

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1326518689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 MARSHALL ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560824500",
            "telephone_number": "507-931-8040",
            "fax_number": "507-931-8060"
        },
        {
            "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",
            "fax_number": "507-931-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOSE",
        "first_name": "KAHLYNN",
        "middle_name": "MARIE",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPCC",
            "identifier": "CC01972",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peter, MN

Sources for this page

Verify at the official NPI Registry.