Individual provider Active NPI

Nancy Nyabuti

  • Professional Counselor
  • Maple Grove, MN
National Provider Identifier
1407677909
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5548 Issued in MN
Practice address
13603 80TH Cir N
Maple Grove, MN 55369-8961
Phone
(763) 274-3120
Fax
(763) 274-3121
NPI assigned
Oct 18, 2024
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5548 MN Primary

Addresses

Primary practice location

13603 80TH Cir N
Maple Grove, MN 55369-8961

Mailing address

7960 Orchid LN N
Maple Grove, MN 55311-2186
Phone (612) 807-0456

Other names 1

  • Mrs. Nancy Kinara Former name

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
I20260623000740 MN Practitioner - Mental Health Counselor 3375016256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5548MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. CurrentSince Oct 20, 2024 Accepting new patients
Specthrive Wellness & Behavioral Health Professional CurrentSince Nov 30, 2025 Accepting new patients

Locations

13603 80th Cir N
Maple Grove, MN 55369
Phone (763) 274-3120

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1407677909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 ORCHID LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112186",
            "telephone_number": "612-807-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13603 80TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553698961",
            "telephone_number": "763-274-3120",
            "fax_number": "763-274-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYABUTI",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "5548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "KINARA",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.