Katelyn Magnan Iverson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5145 Issued in MN

Practice address

299 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-5869

Phone

(651) 240-2206

Fax

(612) 446-5766

NPI assigned

Jan 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wild Tree Psychotherapy LLCGroup PAC ID 8426408881, 9 clinicians

Vayda Mental Health Collaborative PLLCGroup PAC ID 3375012453, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Vayda Mental Health Collaborative PLLC

  • Clinical Psychologist
  • Coon Rapids, MN
  • NPI 1770194417
  Medicare reassignment Care Compare group NPD
• Wild Tree Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1528451408
  Medicare reassignment Care Compare group NPD
• Sarah C. Chambers, P.a.

  • Health Service Clinic/Center
  • Saint Paul, MN
  • NPI 1942358379
  NPD (past)

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1497460976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EMERSON AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302657",
            "telephone_number": "763-516-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335869",
            "telephone_number": "651-240-2206",
            "fax_number": "612-446-5766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 4th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551102875",
            "country_code": "US",
            "telephone_number": "651-212-4920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "KATELYN",
        "middle_name": "MAGNAN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "5145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nasro Abdinur Isaq, MD
• Mohamed Ali Ismail
• Olukole K Israel Payne
• Mari B Ito, MD
• Julie Iverson
• Sandra L Iverson, CPNP
• Jewelle Ruth Jacklen, ATC
• Jessica M Jacklitch, PT
• Deborah Jacobi, RDH
• Nicole Jacobi, MD

• Mental Health Counselor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.