Individual provider Active NPI

Kari Lyn Wampler, MA, LMFT

  • Marriage & Family Therapist
  • Forest Lake, MN
National Provider Identifier
1609043876
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
244 Lake St N
Forest Lake, MN 55025-2517
Phone
(651) 464-3685
NPI assigned
May 15, 2008
Last updated
Feb 10, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

244 Lake St N
Forest Lake, MN 55025-2517

Mailing address

7092 Polaris LN N
Maple Grove, MN 55311-3223
Phone (763) 420-5474

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
I20240213004393 MN Practitioner - Mental Health Counselor 7315381720 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1946MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborative Counseling LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Lakes Center for Youth and Families Mental Health Past Accepting new patients

Locations

7925 Stone Creek Dr
Ste 120
Chanhassen, MN 55317

12918 63rd Ave N
Maple Grove, MN 55369
Phone (612) 643-0236

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1609043876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7092 POLARIS LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113223",
            "telephone_number": "763-420-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 LAKE ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252517",
            "telephone_number": "651-464-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMPLER",
        "first_name": "KARI",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Lake, MN

Sources for this page

Verify at the official NPI Registry.