Individual provider Active NPI

Kenna Rae Millea, MA, LMFT

  • Marriage & Family Therapist
  • Bloomington, MN
National Provider Identifier
1437679230
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
9900 Lyndale Ave S
Bloomington, MN 55420-4733
Phone
(317) 753-4465
NPI assigned
Jun 22, 2017
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

9900 Lyndale Ave S
Bloomington, MN 55420-4733

Mailing address

7400 Metro Blvd Ste 220
Minneapolis, MN 55439-2321

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
I20260218003155 MN Practitioner - Marriage and Family Therapist 5294212270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin Center for Integration LLCGroup PAC ID 6406333475, 4 clinicians

Practice addresses (Care Compare)

3204 E 43Rd St
Minneapolis, MN 55406-3858
Phone (651) 300-2150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Center for Integration LLC Marriage & Family Therapist CurrentSince Jan 1, 2025 Accepting new patients

Locations

9900 Lyndale Ave S
Bloomington, MN 55420
Phone (317) 753-4465

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1437679230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 220",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554392321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 LYNDALE AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204733",
            "telephone_number": "317-753-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLEA",
        "first_name": "KENNA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.