Individual provider Active NPI

Kathryn Eberley

  • Marriage & Family Therapist
  • Minnetonka, MN
National Provider Identifier
1346888609
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4543 Issued in MN
Practice address
13100 Wayzata Blvd Ste 200
Minnetonka, MN 55305-1810
Phone
(952) 206-2040
Fax
(952) 209-2041
NPI assigned
Dec 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4543 MN Primary

Addresses

Primary practice location

13100 Wayzata Blvd Ste 200
Minnetonka, MN 55305-1810

Mailing address

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (651) 628-9566

Other names 1

  • Kathryn Eberley Professional name

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
I20240109003196 MN Practitioner - Marriage and Family Therapist 6800247396 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Range Regional Health Services CurrentSince Sep 15, 2025 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2024 Accepting new patients
Range Regional Health Services CurrentSince Sep 15, 2025 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2024 Accepting new patients
Fairview Express Care Current Accepting new patients
Range Regional Health Services Current Accepting new patients

Locations

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

45 10th St W
Ste 3000
Saint Paul, MN 55102
Phone (651) 326-4800

Organizations & group practices 6

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": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1346888609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 WAYZATA BLVD STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051810",
            "telephone_number": "952-206-2040",
            "fax_number": "952-209-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLEY",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "EBERLEY",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.