Kristine A Doten, MA, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01429 Issued in MN

Practice address

11292 86TH Ave N Ste 106
Maple Grove, MN 55369-4510

Phone

(952) 300-5908

NPI assigned

Dec 11, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

4 Counsel PAGroup PAC ID 3971044124, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• 4 Counsel, P.a.

  • Mental Health Counselor
  • Maple Grove, MN
  • NPI 1699202952
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1700284452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11292 86TH AVE N STE 106",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11292 86TH AVE N STE 106",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "952-300-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTEN",
        "first_name": "KRISTINE",
        "middle_name": "A",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MN",
            "license": "01687",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "637688900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Don Sealock, O.D., P.a.
• Kristine Dooley, OTR
• Pamela D Doorenbos, M.D.
• Naomi Nicole Doriott Larson, M.A., LPC
• Natalia Semenovna Dorland, M.D.
• Shaun Douglass, PTA
• Tyler J Douglass, PT
• Jessica A Drapcho, DDS
• Dreamlife Destiny LLC
• John Daniel Dryer, MD

• Mental Health Counselor in Maple Grove, MN
• Providers in Maple Grove, 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 Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.