Kori Jill Guza, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02287 Issued in MN

Practice address

1210 5TH Ave
Worthington, MN 56187-2432

Phone

(507) 376-4141

Fax

(507) 376-4494

NPI assigned

Nov 21, 2019

Sex

Female

Sole proprietor

Yes

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwestern Mental Health Center IncGroup PAC ID 7012816812, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Southwestern Mental Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Luverne, MN
  • NPI 1487654562
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1548806839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 175",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561870175",
            "telephone_number": "507-376-4141",
            "fax_number": "507-376-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 5TH AVE",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872432",
            "telephone_number": "507-376-4141",
            "fax_number": "507-376-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZA",
        "first_name": "KORI",
        "middle_name": "JILL",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy John Grossman, DDS
• Tonya Anne Grothe-Bumgardner, MS
• Kathy Gruis, MA, LPCC
• Kim D Grymaloski, M.D.
• Mitzi Johali Guizar Cardenas
• Scott Joseph Haas, O.D.
• Stanley George Haas, DDS
• Bryan P Hagen, RPH
• Stephanie Hagen
• Lonnie Roger Haken, DC

• Mental Health Counselor in Worthington, MN
• Providers in Worthington, 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 Nov 21, 2019; 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.