Active NPI
Samantha Marie Kallberg, PSYD, LP
- Counseling Psychologist
- Hampton, MN
National Provider Identifier
1801430277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP6987
- Practice address
- 23629 Inga Ave
Hampton, MN 55031-9776 - Phone
- (218) 590-9905
- NPI assigned
- Oct 29, 2019
- Last updated
- Apr 29, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP6987 | MN | Primary |
Addresses
Primary practice location
23629 Inga Ave
Hampton, MN 55031-9776
Mailing address
23629 Inga Ave
Hampton, MN 55031-9776
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 |
|---|---|---|---|
| LP6987 | MN | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samantha Kallberg | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1801430277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23629 INGA AVE",
"city": "HAMPTON",
"state": "MN",
"postal_code": "550319776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23629 INGA AVE",
"city": "HAMPTON",
"state": "MN",
"postal_code": "550319776",
"telephone_number": "218-590-9905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALLBERG",
"first_name": "SAMANTHA",
"middle_name": "MARIE",
"credential": "PSYD, LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-29",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP6987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.