Stephanie Kandie, MA, LADC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

5380 Bounty St SE
Prior Lake, MN 55372-2501

Phone

(763) 327-7061

Fax

(612) 488-0596

NPI assigned

Oct 26, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie Enola Contreras Romero Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Enlightened Path Behavioral Health & Wellness, LLC.,

  • Mental Health Counselor
  • Prior Lake, MN
  • NPI 1831813765
  NPD Authorized official
• The Family Partnership

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1487708616
  NPD (past)

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1639779135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 BOUNTY ST SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722501",
            "telephone_number": "763-327-7061",
            "fax_number": "612-488-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 BOUNTY ST SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722501",
            "telephone_number": "763-327-7061",
            "fax_number": "612-488-0596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4123 E Lake St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554062255",
            "country_code": "US",
            "telephone_number": "612-729-0340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDIE",
        "first_name": "STEPHANIE",
        "credential": "MA, LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "CONTRERAS ROMERO",
            "middle_name": "ENOLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allen Jerome Johnson
• Kathryn Lynn Jonsrud, R.PH
• Charles Howard Jorenby, MA, LP
• Zachary Thomas Kahmeyer, M.A., LPCC
• Kala Counseling Services
• Ke Holdings LLC
• Kathryn Keil, LSN, RN
• Wade Keller, MA, LAMFT
• Dana Kelly, RN,C
• Kes Chiropractic, PA

• Mental Health Counselor in Prior Lake, MN
• Providers in Prior Lake, 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 Oct 4, 2022; 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.