Individual provider Active NPI

Karen Lynn Hailey, MA, LPCC

  • Professional Counselor
  • Bloomington, MN
National Provider Identifier
1558887273
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2348 Issued in MN
Practice address
1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone
(952) 767-2267
Fax
(612) 728-5301
NPI assigned
Aug 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2348 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230

Mailing address

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone (952) 767-2287

Other practice location 1

16180 Hastings Ave SE
Prior Lake, MN 55372-9227
Phone (952) 443-4600

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
I20231228003499 MN Practitioner - Mental Health Counselor 9931559234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2348MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Jan 1, 2024 Accepting new patients
Fraser PastSince Jan 19, 2020 Accepting new patients

Locations

1801 American Blvd E
Ste 8
Minneapolis, MN 55425
Phone (612) 400-6173

9120 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 231-2590

2400 W 64th St
Richfield, MN 55423
Phone (612) 767-5166

Organizations & group practices 2

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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558887273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "952-767-2287",
            "fax_number": "612-728-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "952-767-2267",
            "fax_number": "612-728-5301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16180 Hastings Ave SE",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "553729227",
            "country_code": "US",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAILEY",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-21",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2348",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.