Active NPI
Kaitlyn Taylor Lake, MS
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1629941000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1200 Marquette Ave
Minneapolis, MN 55403-2419 - Phone
- (612) 503-1954
- NPI assigned
- Sep 24, 2025
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MN | ||
| Mental Health Counselor | 101YM0800X | MN | Primary |
Addresses
Primary practice location
1200 Marquette Ave
Minneapolis, MN 55403-2419
Mailing address
1200 Marquette Ave
Minneapolis, MN 55403-2419
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 Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1629941000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 MARQUETTE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554032419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 MARQUETTE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554032419",
"telephone_number": "612-503-1954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "KAITLYN",
"middle_name": "TAYLOR",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-24",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": null,
"primary": true
}
],
"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 Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.