Individual provider Active NPI

Mary B Kurtz, LADC, LPCC

  • Professional Counselor
  • Saint Paul, MN
National Provider Identifier
1407461809
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2590 Issued in MN
Practice address
1619 Dayton Ave Ste 325
Saint Paul, MN 55104-6495
Phone
(612) 987-6120
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303714 MN
Professional Counselor 101YP2500X 2590 MN Primary

Addresses

Primary practice location

1619 Dayton Ave Ste 325
Saint Paul, MN 55104-6495

Mailing address

747 Cottage Ave E
Saint Paul, MN 55106-1708
Phone (612) 987-6120

Other names 1

  • Mary M Brooks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
303714MNMDAddiction (Substance Use Disorder) Counselor
2590MNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1407461809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 COTTAGE AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551061708",
            "telephone_number": "612-987-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE STE 325",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046495",
            "telephone_number": "612-987-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "MARY",
        "middle_name": "B",
        "credential": "LADC, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303714",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BROOKS",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.