Individual provider Active NPI

Katie Kussard

  • Marriage & Family Therapist
  • Albuquerque, NM
National Provider Identifier
1679754550
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1758 Issued in MN
Practice address
120 Aliso Dr SE
Albuquerque, NM 87108-2693
Phone
(952) 228-0047
NPI assigned
Nov 19, 2007
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1758 MN Primary

Addresses

Primary practice location

120 Aliso Dr SE
Albuquerque, NM 87108-2693

Mailing address

11820 Holiday Ave NE
Albuquerque, NM 87111-5234

Other practice location 1

1670 Robert St S Ste 149
Saint Paul, MN 55118-3918
Phone (952) 228-0047

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

State licenses

LicenseStateTypeSpecialty
1758MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients
Mindful Meander Psychotherapy, LLC Marriage & Family Therapist CurrentSince May 18, 2025 Accepting new patients
Truly Willow Psychotherapy PLLC CurrentSince May 18, 2025 Accepting new patients

Locations

1670 Robert St S
West St Paul, MN 55118
Phone (612) 270-2668

120 Aliso Dr SE
Albuquerque, NM 87108
Phone (505) 336-9826

Interoperability endpoints

  • Direct secure messaging: katiekussard@tdh.allscriptsdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1679754550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 HOLIDAY AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ALISO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082693",
            "telephone_number": "952-228-0047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Robert St S Ste 149",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551183918",
            "country_code": "US",
            "telephone_number": "952-228-0047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSSARD",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.