Kathlyn Nelson PHD LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP 3967 Issued in MN

Legal business name

KATHLYN NELSON PHD LLC

Practice address

7616 Currell Blvd
Ste. 280
Woodbury, MN 55125-2290

Phone

(651) 341-9667

Fax

(651) 735-7527

NPI assigned

Aug 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kathlyn Elvera Nelson, PHD

Title

Sole Proprietor

Phone

(651) 341-9667

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rome Alexander, LICSW

  • Clinical Social Worker
  • Woodbury, MN
  • NPI 1578656856
  NPD (past)

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1609008010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 DOROTHY AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104911",
            "telephone_number": "651-341-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7616 CURRELL BLVD",
            "address_2": "STE. 280",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252290",
            "telephone_number": "651-341-9667",
            "fax_number": "651-735-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLYN NELSON PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KATHLYN",
        "authorized_official_middle_name": "ELVERA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "651-341-9667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP 3967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "459510600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1093804338",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mekha Joy Karot, PA-C
• Joshua Timothy Kasper, DPT
• Allison Marie Johnson Kassen, D.D.S.
• Chavelle Kimberley Kassie
• Katherine K Thomas, Inc
• Tarikua Katiso
• Kattar Consulting, PC
• Dana Lynn Kaufman, PAC
• Eric Lee Kaufmann, DPT
• Teagan Audrey Kautzman, PA-C

• Community/Behavioral Health Agency in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.