Active NPI
Reka Kerlin, LPCC
- Mental Health Counselor
- Edina, MN
National Provider Identifier
1477847697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC01986
- Practice address
- 6550 York Ave S Ste 503
Edina, MN 55435-2336 - Phone
- (952) 426-3034
- NPI assigned
- Jun 6, 2011
- Last updated
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC01986 | MN | Primary |
Addresses
Primary practice location
6550 York Ave S Ste 503
Edina, MN 55435-2336
Mailing address
7755 Spring Lake Rd
Saint Paul, MN 55112-5840
Phone (857) 928-9625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC01986 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Mullenbach, PHD, LP, Inc | Past | Accepting new patients |
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": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1477847697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7755 SPRING LAKE RD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551125840",
"telephone_number": "857-928-9625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6550 YORK AVE S STE 503",
"city": "EDINA",
"state": "MN",
"postal_code": "554352336",
"telephone_number": "952-426-3034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERLIN",
"first_name": "REKA",
"name_prefix": "Ms.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-06",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC01986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.