Kingdom in Action

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1075563-2-CDT Issued in MN

Legal business name

KINGDOM IN ACTION

Practice address

9500 Minnetonka Blvd
St Louis Park, MN 55426-2944

Phone

(952) 933-4808

NPI assigned

Dec 15, 2014

Organization subpart

Yes

Parent organization

GIVING IN GRACE AT SOULS HARBORAs reported in NPPES

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

Authorized official

Name

Reginald Fitzgerald Lewis

Title

Executive Director

Phone

(952) 933-4808

Specialties & licenses 8

Addresses

Part of

Kingdom in Action

Locations

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1841698339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 MINNETONKA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262944",
            "telephone_number": "952-933-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MINNETONKA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262944",
            "telephone_number": "952-933-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM IN ACTION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIVING IN GRACE AT SOULS HARBOR",
        "enumeration_date": "2014-12-15",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "FITZGERALD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "952-933-4808"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "1075563-2-CDT",
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MN",
            "license": "1075563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Semra Kimyon
• Steven L Kind, M.D.
• King Tooth PLLC
• Lindsey Jo King, D.C
• Malia L King, PTA
• Makenzie Kinney
• Lori Dina Kinstad, LICSW
• Andrea Marie Kinzer, OT
• Kristina Kircher
• Heather Kirkham

• Addiction (Substance Use Disorder) Counselor in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.