Kristine Marie Shoen, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17553 Issued in MN

Practice address

112 W 1St St
Suite 104
Fairmont, MN 56031-1743

Phone

(507) 399-2149

Fax

(507) 399-2159

NPI assigned

Feb 7, 2008

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

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• JJ Counseling LLC

  • Clinical Social Worker
  • Fairmont, MN
  • NPI 1962067405

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1558549907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 DOWNTOWN PLZ",
            "address_2": "SUITE 104",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311726",
            "telephone_number": "507-399-2149",
            "fax_number": "507-399-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W 1ST ST",
            "address_2": "SUITE 104",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560311743",
            "telephone_number": "507-399-2149",
            "fax_number": "507-399-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEN",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-07",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "17553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Seibert, OD
• Ryan Selbrade
• Kelly Ray Shantz, CRNA
• Timothy Sheneman, D.O.
• Anne Sheppard, RD
• Maurice Lee Shoen
• Rhonda Lee Shoen, RN
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shoptikal LLC

• Mental Health Counselor in Fairmont, MN
• Providers in Fairmont, 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 Sep 8, 2016; 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.