Individual provider Active NPI

Kathryn L Schesso, LMFT

  • Marriage & Family Therapist
  • Isanti, MN
National Provider Identifier
1356422760
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
966 Issued in MN
Practice address
401 E Dual Blvd Ste 120
Isanti, MN 55040
Phone
(763) 600-2911
Fax
(763) 244-1243
NPI assigned
Oct 18, 2006
Last updated
Jun 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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 966 MN Primary

Addresses

Primary practice location

401 E Dual Blvd Ste 120
Isanti, MN 55040

Mailing address

401 E Dual Blvd Ste 120
Isanti, MN 55040-7164
Phone (763) 600-2911

Other practice location 1

320 3rd St NW
Faribault, MN 55021-5195
Phone (507) 333-6498

Other identifiers 1

IdentifierTypeStateIssuer
4550820-00MedicaidMN

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
I20240708000552 MN Practitioner - Marriage and Family Therapist 1557805116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Online Counseling LLCGroup PAC ID 3072849207, 13 clinicians

Practice addresses (Care Compare)

1310 Hwy 96 E
Suite 104C
White Bear Lake, MN 55110-3618
Phone (651) 756-7590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Online Counseling LLC Marriage & Family Therapist CurrentSince May 1, 2024 Accepting new patients
Serenity Circle Counseling, LLC Marriage & Family Therapist Past Accepting new patients

Locations

1310 Highway 96 E
Ste 104C
White Bear Lake, MN 55110
Phone (651) 243-2747

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1356422760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E DUAL BLVD STE 120",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550407164",
            "telephone_number": "763-600-2911",
            "fax_number": "763-244-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E DUAL BLVD STE 120",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "55040",
            "telephone_number": "763-600-2911",
            "fax_number": "763-244-1243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 3rd St NW",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550215195",
            "country_code": "US",
            "telephone_number": "507-333-6498",
            "fax_number": "507-333-6484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHESSO",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4550820-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Isanti, MN

Sources for this page

Verify at the official NPI Registry.