Individual provider Active NPI

Kiersten Marie Telste Brooks, MS

  • Professional Counselor
  • Aurora, CO
National Provider Identifier
1407526312
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0020797 Issued in CO
Practice address
2851 S Parker Rd Ste 1220
Aurora, CO 80014-2733
Phone
(719) 623-2356
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0020797 CO Primary
Professional Counselor 101YP2500X 2957 MN

Addresses

Primary practice location

2851 S Parker Rd Ste 1220
Aurora, CO 80014-2733

Mailing address

11280 86TH Ave N
Maple Grove, MN 55369-4510
Phone (763) 400-7828

Other practice location 1

11280 86th Ave N
Maple Grove, MN 55369-4510
Phone (763) 400-7828

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
I20240923002164 MN Practitioner - Mental Health Counselor 0648711200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC.0020797COMDProfessional Counselor
2957MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Counseling LLC CurrentSince Jul 13, 2024 Accepting new patients
Scott M Yarosh, LLC CurrentSince Nov 1, 2022 Accepting new patients
Healthwise Psychology, PA CurrentSince Nov 1, 2022 Accepting new patients
Clarity Mental Health, PLLC PastSince Aug 16, 2020 Accepting new patients
Clarity Mental Health, PLLC Past Accepting new patients

Locations

12918 63rd Ave N
Maple Grove, MN 55369
Phone (952) 999-1959

11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1407526312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11280 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "763-400-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 S PARKER RD STE 1220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142733",
            "telephone_number": "719-623-2356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11280 86th Ave N",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553694510",
            "country_code": "US",
            "telephone_number": "763-400-7828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KIERSTEN",
        "middle_name": "MARIE TELSTE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0020797",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.