Kara Danielle Ebert, LMFT, PMH-C

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2724 Stillwater St
White Bear Township, MN 55110-2468

Phone

(612) 226-8719

Fax

(651) 666-1762

NPI assigned

Jul 15, 2015

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 identifiers 1

Other names 1

• Kara Danielle Moen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Be Still Services

  • Marriage & Family Therapist
  • Cloquet, MN
  • NPI 1205441391
  NPD Authorized official

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1396129706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2163 US HIGHWAY 8 STE 100-4041",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540248326",
            "telephone_number": "612-226-8719",
            "fax_number": "651-666-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 STILLWATER ST",
            "city": "WHITE BEAR TOWNSHIP",
            "state": "MN",
            "postal_code": "551102468",
            "telephone_number": "612-226-8719",
            "fax_number": "651-666-1762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2163 US Highway 8 Ste 100-4041",
            "address_purpose": "LOCATION",
            "city": "Saint Croix Falls",
            "state": "WI",
            "postal_code": "540248326",
            "country_code": "US",
            "telephone_number": "612-226-8719",
            "fax_number": "651-666-1762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERT",
        "first_name": "KARA",
        "middle_name": "DANIELLE",
        "credential": "LMFT, PMH-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205441391",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARA",
            "last_name": "MOEN",
            "middle_name": "DANIELLE",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kelsey Rose Mickschl, DPT
• Kara Sommerfeld

• All providers in White Bear Township, MN
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.