Kelsi Addabbo

Individual provider Active NPI Marriage & Family Therapist · Faribault, MN

NPI 1326683061 · NPPES record last updated Nov 15, 2019

Key facts

NPI
1326683061
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
410 Central Ave N
Faribault, MN 55021-5217
Phone
(507) 446-0431
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Fernbrook Family Center Inc (31 clinicians)

Practice addresses (Care Compare)

2575 Harvest LN
Owatonna, MN 55060-4305
Phone (507) 446-0431

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240215003318 MN Practitioner - Marriage and Family Therapist 0446694673 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Fernbrook Family Center, Inc Current
since Jan 1, 2024
Accepting new patients
Fernbrook Family Center, Inc Past
since Nov 17, 2019
Accepting new patients
Fernbrook Family Center Past Accepting new patients

Locations

410 Central Ave N
Faribault, MN 55021
Phone (507) 331-3454

2575 Harvest Ln
Owatonna, MN 55060
Phone 5074460431115

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Yes

Addresses

Primary practice location

410 Central Ave N
Faribault, MN 55021-5217

Mailing address

2575 Harvest LN
Owatonna, MN 55060-4305

Other providers in Faribault, MN

All providers in Faribault, MN · Marriage & Family Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.