Active NPI
Yvonne Marie Kilkelly, LICSW, LMFT
- Mental Health Counselor
- Saint Paul, MN
National Provider Identifier
1740328772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 549
- Practice address
- 91 Snelling Ave N
Suite 230
Saint Paul, MN 55104-6753 - Phone
- (651) 642-9509
- Fax
- (651) 642-5909
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1430 | MN | |
| Mental Health Counselor | 101YM0800X | 549 | MN | Primary |
Addresses
Primary practice location
91 Snelling Ave N
Suite 230
Saint Paul, MN 55104-6753
Mailing address
91 Snelling Ave N
Suite 230
Saint Paul, MN 55104-6753
Phone (651) 642-9509
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5G604KI | Other | MN | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1430 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740328772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 SNELLING AVE N",
"address_2": "SUITE 230",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551046753",
"telephone_number": "651-642-9509",
"fax_number": "651-642-5909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 SNELLING AVE N",
"address_2": "SUITE 230",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551046753",
"telephone_number": "651-642-9509",
"fax_number": "651-642-5909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILKELLY",
"first_name": "YVONNE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LICSW, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "1430",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5G604KI",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.