Kristen N Paradise, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

02376 Issued in MN

Practice address

4323 N. Upton Ave.
Minneapolis, MN 55412

Phone

(612) 562-9021

NPI assigned

Feb 28, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Pure Therapy, LLC

  • Adult Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1124702634
  NPD Authorized official
• Genuine Therapy Center

  • Community/Behavioral Health Agency
  • Anoka, MN
  • NPI 1841493608
  NPD (past)
• Optiovillage, Inc

  • Community/Behavioral Health Agency
  • Anoka, MN
  • NPI 1184002784
  NPD (past)

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1740814755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 UPTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 N. UPTON AVE.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55412",
            "telephone_number": "612-562-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARADISE",
        "first_name": "KRISTEN",
        "middle_name": "N",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "02376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paradise@pure-psychedelic.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "4323 N. Upton Ave.",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Saikarthik Papisetty
• Mandy Papke, FNP-C
• Tiffany Rose Paradis, M.D.
• Paradise Autism Center LLC
• Helen Tang Paradise, M.D.
• Vaughn Aaron Paradise
• Katheryn Paral
• Abhiram Parameswaran Pillai, M.B.B.S
• Aniruddha S. Paranjpe, MD
• Michael Parappilly, MD

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, 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, 2023; 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.