Kimberly Marie Masters, M.A., L.P.C.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC00851 Issued in MN

Practice address

3548 Bryant Ave S
Minneapolis, MN 55408

Phone

(612) 822-8227

Fax

(612) 825-4204

NPI assigned

Dec 14, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Birchbark Play Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1861286015
  NPD Authorized official
• Associated Speech and Language Specialists LLC

  • Speech-Language Pathologist
  • St Paul, MN
  • NPI 1881636223
  NPD (past)
• 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": "1418515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1619375250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7112 HARRIET AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554233062",
            "telephone_number": "612-578-2502",
            "fax_number": "651-639-1718"
        },
        {
            "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": "55408",
            "telephone_number": "612-822-8227",
            "fax_number": "612-825-4204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3490 Lexington Ave N",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Shoreview",
            "state": "MN",
            "postal_code": "551268074",
            "country_code": "US",
            "telephone_number": "651-639-0942",
            "fax_number": "651-639-1718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "M.A., L.P.C.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-14",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC00851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Massey
• Cornelia Alysia Massie, MD
• Madison Massoth
• Master of Massage LLC
• David Masterman, PA-C
• Thomas Chrisman Masters II, MD
• Mastery School Inc.
• Justine Welch Mastin, LMFT, LADC
• Elizabeth Mastoloni, MD
• Megan Anne Matack, PHARMD

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.