Kathleen Joleen Herzog, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1776 Issued in MN

Practice address

1125 6TH St SE
Willmar, MN 56201-4675

Phone

(320) 235-4613

NPI assigned

Apr 5, 2018

Last updated

Apr 5, 2018By the provider in NPPES

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woodland Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willmar, MN
  • NPI 1295818862
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1558867614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 E 4TH ST",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553552208",
            "telephone_number": "320-221-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "KATHLEEN",
        "middle_name": "JOLEEN",
        "name_prefix": "Ms.",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Ryan Heminover, ATC/R
• Mykaela J Henrickson
• Jenelle Lee Herkenhoff, LICSW
• Eric Moore Hernandez, M.D., PH.D.
• Rubi Herrera Zelaya
• Kayla Lynn Hess, LICSW
• William E. Hicks, M. D.
• Jarrod John Higgins, MD
• Gretchen Hillesheim, LPCC
• Maria De Jesus Hinojosa, LADC

• Professional Counselor in Willmar, MN
• Providers in Willmar, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.