Active NPI
Kristen Lissette Viscarra, MA
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1588495451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3548 Bryant Ave S
Minneapolis, MN 55408-4119 - Phone
- (612) 822-8227
- NPI assigned
- Aug 12, 2024
- Last updated
- Aug 12, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary | |
| School Counselor | 101YS0200X | 1031410 | MN |
Addresses
Primary practice location
3548 Bryant Ave S
Minneapolis, MN 55408-4119
Mailing address
703 Central Ave NE Apt a
Minneapolis, MN 55414-1102
Phone (602) 432-4066
Other practice location 1
1098 Andersen Ln
Minneapolis, MN 55407-1109
Phone (612) 668-4200
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 |
|---|---|---|---|
| 1031410 | MN | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watercourse Counseling Center | Past | Accepting new patients | |
| The Mental Health Collective | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Minneapolis, MN
- NPI 1932126794
-
- Community/Behavioral Health Agency
- Minneapolis, MN
- NPI 1770847246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1588495451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 CENTRAL AVE NE APT A",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554141102",
"telephone_number": "602-432-4066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3548 BRYANT AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554084119",
"telephone_number": "612-822-8227"
}
],
"practiceLocations": [
{
"address_1": "1098 Andersen Ln",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554071109",
"country_code": "US",
"telephone_number": "612-668-4200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VISCARRA",
"first_name": "KRISTEN",
"middle_name": "LISSETTE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-12",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "MN",
"license": "1031410",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.