Individual provider Active NPI

Kristi Betker, LPCC

  • Professional Counselor
  • Coon Rapids, MN
National Provider Identifier
1528579802
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1631 Issued in MN
Practice address
1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone
(651) 774-0011
Fax
(651) 774-0606
NPI assigned
Oct 13, 2017
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1631 MN Primary

Addresses

Primary practice location

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708

Mailing address

3000 Ames Crossing Rd Ste 600
Eagan, MN 55121-2519
Phone (651) 774-0011

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
I20231226000923 MN Practitioner - Mental Health Counselor 7315397817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
People IncorporatedGroup PAC ID 7012043540, 31 clinicians

Practice addresses (Care Compare)

1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433-4708
Phone (651) 774-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1631MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
People Incorporated CurrentSince Jan 1, 2024 Accepting new patients
People Incorporated CurrentSince Jan 1, 2024 Accepting new patients
Guild Past Accepting new patients
Guild Past Accepting new patients

Locations

1930 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 427-7964

3000 Ames Crossing Rd
Ste 600
Saint Paul, MN 55121
Phone (651) 288-3467

317 York Ave
Saint Paul, MN 55130
Phone (651) 771-0286

Organizations & group practices 4

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1528579802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 AMES CROSSING RD STE 600",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212519",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554334708",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETKER",
        "first_name": "KRISTI",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.