Kayla Polson, MSED, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1165 Issued in MN

Practice address

1406 E 2ND St
Duluth, MN 55805

Phone

(218) 624-5683

Fax

(218) 624-5736

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kayla Wilson Former name

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Human Development CenterGroup PAC ID 2961485909, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

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.

• Brightwater Health Dba Human Development Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1194790733

  WI

  Medicare reassignment Care Compare group NPD
• Brightwater Health Dba Human Development Center

  dba Human Development Center

  • Community/Behavioral Health Agency
  • Superior, WI
  • NPI 1407021579
  NPD
• Brightwater Health Dba Human Development Center

  • Community/Behavioral Health Agency
  • Cloquet, MN
  • NPI 1114048527
  NPD (past)

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1386002905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-728-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-624-5683",
            "fax_number": "218-624-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSON",
        "first_name": "KAYLA",
        "credential": "MSED, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "WILSON",
            "credential": "MSED, LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Phillip Poirier
• Amanda Jean Pokorny, RPH, PHARMD
• Polinsky Medical Rehabilitation Center (Essentia Health Polinsky Medical Rehabilitation Center)
• Mallory Polivka, M.A., R-DMT
• Nicholas David Polovitz, LGSW
• Jeffrey Polzin, D.M.D.
• Julie A Polzin
• Kristina Marie Polzin, L.AC
• Scott Alan Polzin, DDS
• Brittany Pope-Sears

• Professional Counselor in Duluth, MN
• Providers in Duluth, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.