Individual provider Active NPI

Katharine Simpson, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1417775289
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4612 Issued in MN
Practice address
4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone
(612) 825-4792
NPI assigned
Oct 1, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4612 MN Primary

Addresses

Primary practice location

4208 Park Glen Rd
Minneapolis, MN 55416-4758

Mailing address

4208 Park Glen Rd
Minneapolis, MN 55416-4758
Phone (612) 825-4792

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
I20241122003484 MN Practitioner - Mental Health Counselor 0244765535 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4612MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
CGC LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

333 Washington Ave N
Minneapolis, MN 55401
Phone (612) 349-2797

4208 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 825-4792

Organizations & group practices 1

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1417775289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 PARK GLEN RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "612-825-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 PARK GLEN RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164758",
            "telephone_number": "612-825-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "KATHARINE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.