Individual provider Active NPI

Kimberly Kay Schaefbauer, MED, LPCC

  • Professional Counselor
  • Brainerd, MN
National Provider Identifier
1720535974
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC01293 Issued in MN
Practice address
823 Maple St
Brainerd, MN 56401-3770
Phone
(218) 829-3235
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01293 MN Primary

Addresses

Primary practice location

823 Maple St
Brainerd, MN 56401-3770

Mailing address

1906 5TH Ave SE
PO Box 367
Little Falls, MN 56345-3317
Phone (320) 632-6647

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
I20240610002330 MN Practitioner - Mental Health Counselor 6800294315 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
CC01293MNMDProfessional Counselor
1293MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Pines Mental Health Center, Inc. CurrentSince Apr 2, 2024 Accepting new patients
Northern Pines Mental Health Center, Inc. PastSince Apr 2, 2024 Accepting new patients

Locations

13 3rd St NE
Aitkin, MN 56431
Phone (218) 928-8003

823 Maple St
Brainerd, MN 56401
Phone (218) 454-3826

323 S 9th St
Brainerd, MN 56401

606 Front St
Brainerd, MN 56401
Phone (218) 232-6247

201 W Laurel St
Brainerd, MN 56401
Phone (218) 454-3844

520 NW 5th St
Brainerd, MN 56401
Phone (218) 821-7818

1906 5th Ave SE
Little Falls, MN 56345
Phone (320) 492-2946

16 9th St SE
Long Prairie, MN 56347
Phone (320) 732-6602

200 4th St NE
Staples, MN 56479
Phone (218) 541-5043

11 2nd St SW
Ste 1
Wadena, MN 56482
Phone (218) 631-1714

Organizations & group practices 2

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1720535974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 5TH AVE SE",
            "address_2": "PO BOX 367",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453317",
            "telephone_number": "320-632-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 MAPLE ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013770",
            "telephone_number": "218-829-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFBAUER",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "credential": "MED, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.