Kiah G Staloch, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6386 Issued in MN

Practice address

1027 Washington Ave
Detroit Lakes, MN 56501-3409

Phone

(218) 847-5611

NPI assigned

Aug 21, 2015

Last updated

Jun 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagan Counseling ClinicGroup PAC ID 2860304045, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eagan Counseling Clinic

  • Clinical Psychologist
  • Eagan, MN
  • NPI 1144311184
  Medicare reassignment Care Compare group NPD
• The Mental Health Collective

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1932126794
  NPD (past)
• Watercourse Counseling Center

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1770847246
  NPD (past)

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1619344900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-847-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3548 Bryant Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084119",
            "country_code": "US",
            "telephone_number": "612-822-8227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Hollinger St",
            "address_purpose": "LOCATION",
            "city": "Park Rapids",
            "state": "MN",
            "postal_code": "564701300",
            "country_code": "US",
            "telephone_number": "218-252-2785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALOCH",
        "first_name": "KIAH",
        "middle_name": "G",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Marys Regional Health Center (Essentia Health Home Care West)
• St. Mary's Regional Health Center (St. Mary's Nursing Center DME)
• St. Mary's Regional Health Center
• St. Marys Regional Health Center (Essentia Health St. Mary's- Detroit Lakes)
• Patricia Marie Stalberger, PT
• Alyssa Starbeck
• Katherine A Starbeck, APRN, CNP
• Donald L Steinmetz, DDS
• Alexa Stelzer, RD
• Beth Sternhagen

• Clinical Psychologist in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.