Individual provider Active NPI

Maria Kathryn Anderson, LMFT

  • Mental Health Counselor
  • Worthington, MN
National Provider Identifier
1700397221
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3079 Issued in MN
Practice address
1210 5TH Ave
Worthington, MN 56187-2432
Phone
(507) 329-4987
NPI assigned
Oct 24, 2017
Last updated
Oct 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3079 MN Primary

Addresses

Primary practice location

1210 5TH Ave
Worthington, MN 56187-2432

Mailing address

1210 5TH Ave
Worthington, MN 56187-2432

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
I20240415002823 MN Practitioner - Mental Health Counselor 0749627495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Mental Health Center IncGroup PAC ID 7012816812, 16 clinicians

Practice addresses (Care Compare)

1210 5TH Ave
Worthington, MN 56187-2432
Phone (507) 376-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3079MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Mental Health Center Inc CurrentSince Feb 25, 2024 Accepting new patients

Locations

117 S Spring St
Luverne, MN 56156
Phone (507) 283-9511

Organizations & group practices 1

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": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1700397221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 5TH AVE",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 5TH AVE",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872432",
            "telephone_number": "507-329-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARIA",
        "middle_name": "KATHRYN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.