Active NPI
Lisa Kleingarn, MA
- Mental Health Counselor
- Eden Prairie, MN
National Provider Identifier
1588197388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 6542 Regency LN
Suite 201
Eden Prairie, MN 55344-7847 - Phone
- (612) 400-7832
- NPI assigned
- Apr 7, 2017
- Last updated
- Apr 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
6542 Regency LN
Suite 201
Eden Prairie, MN 55344-7847
Mailing address
5224 17TH Ave S
Minneapolis, MN 55417-1851
Phone (612) 598-0087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3587 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491523200000",
"number": "1588197388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5224 17TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554171851",
"telephone_number": "612-598-0087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6542 REGENCY LN",
"address_2": "SUITE 201",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447847",
"telephone_number": "612-400-7832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEINGARN",
"first_name": "LISA",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-07",
"last_updated": "2017-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.