Individual provider Active NPI

Molly Kathryn Kolquist-Kucza, PSYD, LP

  • Clinical Psychologist
  • Duluth, MN
National Provider Identifier
1649943366
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP6837 Issued in MN
Practice address
530 E 2ND St BLDG E
Duluth, MN 55805-1913
Phone
(218) 786-8364
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP6837 MN Primary

Addresses

Primary practice location

530 E 2ND St BLDG E
Duluth, MN 55805-1913

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other names 1

  • Molly Kathryn Kolquist Former name

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
I20221109001758 MN Practitioner - Clinical Psychologist 9830566504 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. CurrentSince Nov 21, 2022 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic LTD CurrentSince Nov 21, 2022 Accepting new patients
SMDC Medical Center CurrentSince Nov 21, 2022 Accepting new patients
SMDC Medical Center PastSince Nov 21, 2022 Accepting new patients

Locations

502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762

530 E 2nd St
Bldg E
Duluth, MN 55805
Phone (218) 786-1186

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

615 Pecan Ave
Duluth, MN 55811
Phone (218) 355-2100

530 E 2nd St
Duluth, MN 55805
Phone (218) 786-5300

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1649943366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 2ND ST BLDG E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLQUIST-KUCZA",
        "first_name": "MOLLY",
        "middle_name": "KATHRYN",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "KOLQUIST",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.