Kelli Nowak, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC01649 Issued in MN

Practice address

716 Sibley Ave
Gaylord, MN 55334-2386

Phone

(507) 237-9989

NPI assigned

Aug 7, 2015

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Sioux Trails Mental Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Ulm, MN
  • NPI 1902909914
  NPD (past)

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1730565144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "GAYLORD",
            "state": "MN",
            "postal_code": "553340393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 SIBLEY AVE",
            "city": "GAYLORD",
            "state": "MN",
            "postal_code": "553342386",
            "telephone_number": "507-237-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 Oakton St",
            "address_2": "Door 5",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600772630",
            "country_code": "US",
            "telephone_number": "773-751-7920 x7924",
            "fax_number": "847-674-2651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "KELLI",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01649",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna M Krautkremer, PTA
• Shannon Kuelbs, SLP
• Geri Loose
• McGuire Family Chiropractic PA
• McKayla Nicole Narveson
• Oak Terrace Health Care Center of Gaylord ,LLC
• Oak Terrace Senior Housing of Gaylord,LLC
• Emily Ayleen Orocio
• Overson Family Based Counseling Services, Inc
• Jaime Petersen, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.