Kayla M Pavelka, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

5125 County Road 101
Minnetonka, MN 55345-4156

Phone

(952) 395-9966

Fax

(952) 932-9827

NPI assigned

Oct 8, 2020

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

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1669079042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454156",
            "telephone_number": "952-395-9966",
            "fax_number": "952-932-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 COUNTY ROAD 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454156",
            "telephone_number": "952-395-9966",
            "fax_number": "952-932-9827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8670 210th St W",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550447000",
            "country_code": "US",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVELKA",
        "first_name": "KAYLA",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.