Bethany S Kunkel, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

00412 Issued in MN

Practice address

7000 57TH Ave N Ste 100
Crystal, MN 55428-3479

Phone

(612) 752-8340

NPI assigned

Oct 18, 2012

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

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

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collaborative Counseling LLCGroup PAC ID 3678711900, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Collaborative Counseling LLC

  • Mental Health Counselor
  • Maple Grove, MN
  • NPI 1598034324
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1386997153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 57TH AVE N STE 100",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 57TH AVE N STE 100",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283479",
            "telephone_number": "612-752-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "BETHANY",
        "middle_name": "S",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "00412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kraina Supplies
• James R Krause, MD
• Darrell A Krieger, MD
• Caitlin Ruth Kuck, MD
• Elizabeth E Kuettner, MC, LPC, CPRP
• Mary K Laconic, OD
• Aaron Thomas Lahoud, O.D.
• Lisa Lapointe, PA-C
• Robert Larbi-Odam, MD
• Katherine McCourt Robinson Larson, PA C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.