Katelyn Maciej, MA, LADC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC02177 Issued in MN

Practice address

324 W Superior St BLDG Suite620
Duluth, MN 55802-1701

Phone

(218) 606-1797

NPI assigned

Aug 8, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 8, 2024 through Mar 8, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1780239442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST BLDG SUITE620",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021701",
            "telephone_number": "218-606-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST BLDG SUITE620",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021701",
            "telephone_number": "218-606-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEJ",
        "first_name": "KATELYN",
        "credential": "MA, LADC, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304287",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "katie@mapbhc.com",
            "affiliation": "N",
            "address_1": "324 W Superior St Bldg Suite620",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558021701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• M Dental PLLC
• Danielle Amber Macdonald, PHARMACIST
• Deborah Ann Macdonald, APRN, CNS
• Crystal Marie Macfarlane, RN
• Jordan Wolfgang Mach
• Jennifer Maciewski
• Anthony John Macioce, D.C.
• Laura Lynn Mackinnon
• Kathleen L Madden, RN, CNP
• Erin McCutchen Maddy, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.