Active NPI
Kelly Swanson, MA, LPCC, RPT
- Mental Health Counselor
- Pine City, MN
National Provider Identifier
1578037594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC02023
- Practice address
- 220 Railroad St SE
Pine City, MN 55063-1540 - Phone
- (320) 629-7600
- Fax
- (651) 925-0071
- NPI assigned
- Jan 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC02023 | MN | Primary |
Addresses
Primary practice location
220 Railroad St SE
Pine City, MN 55063-1540
Mailing address
2463 180TH Ave
Mora, MN 55051-7219
Phone (320) 291-7291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC02023 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547251200000",
"number": "1578037594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2463 180TH AVE",
"city": "MORA",
"state": "MN",
"postal_code": "550517219",
"telephone_number": "320-291-7291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 RAILROAD ST SE",
"city": "PINE CITY",
"state": "MN",
"postal_code": "550631540",
"telephone_number": "320-629-7600",
"fax_number": "651-925-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "MA, LPCC, RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-12",
"last_updated": "2019-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC02023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine City, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.