Katie Lynn Nelson, MA, LPCC
Individual provider Active NPI Mental Health Counselor · Mora, MN
NPI 1831663814 · NPPES record last updated Dec 18, 2024
Key facts
- NPI
- 1831663814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CC02027 (MN)
- Practice address
- 23 Pine St N
Mora, MN 55051-1320 - Phone
- (320) 679-6964
- NPI assigned
- Jan 14, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
12580 192ND CT NW
Suite F
Elk River, MN 55330-5085
7525 Mitchell Rd
Suite 215
Eden Prairie, MN 55344-1957
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251015002411 | MN | Practitioner - Mental Health Counselor | 3971090788 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC02027 | MN | MD | Mental Health Counselor |
| 2027 | MN | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Love the Journey Inc | Mental Health | Current |
Accepting new patients |
| Geryol Consulting LLC | Current |
Accepting new patients |
Locations
12580 192nd Ct NW
Ste F
Elk River, MN 55330
Phone (763) 200-6046
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC02027 | MN | Yes |
Addresses
Primary practice location
23 Pine St N
Mora, MN 55051-1320
Mailing address
12580 192ND CT NW Ste F
Elk River, MN 55330-5085
Phone (218) 251-1546
Other names
- Ms. Katie Lynn Burggraff
Other providers in Mora, MN
- Jean Mork
- Joseph Troy Mork
- Kaitlyn Marie Moss
- Thomas Matthew Mullin
- Whitney Naumann
- Mark Albert Nelson Jr.
- Neve Inc
- Jennifer Niedzielski
- Brian D Niskanen
- Jason Nordby
All providers in Mora, MN · Mental Health Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.