Individual provider Active NPI

Julie Kieke, MA LMFT

  • Marriage & Family Therapist
  • Saint Cloud, MN
National Provider Identifier
1437193398
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1309 Issued in MN
Practice address
600 25TH Ave S Ste 109
Saint Cloud, MN 56301
Phone
(320) 255-0343
Fax
(320) 654-0318
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1309 MN Primary

Addresses

Primary practice location

600 25TH Ave S Ste 109
Saint Cloud, MN 56301

Mailing address

600 25TH Ave S Ste 109
Saint Cloud, MN 56301-4820
Phone (320) 255-0343

Other identifiers 5

IdentifierTypeStateIssuer
335415600MedicaidMN
922241042558OtherPREFERRED ONE
HP48615OtherHEALTH PARTNERS
387L3KIOtherBCBS
137137C851OtherUCARE

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
I20240918003205 MN Practitioner - Marriage and Family Therapist 2567814791 Practice locations: Saint Cloud, MN

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

600 25TH Ave S
Suite 109
Saint Cloud, MN 56301-4820
Phone (320) 255-0343

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1437193398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S STE 109",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014820",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S STE 109",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEKE",
        "first_name": "JULIE",
        "name_prefix": "Ms.",
        "credential": "MA LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335415600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "922241042558",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP48615",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "387L3KI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "137137C851",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.