Individual provider Active NPI

Kelsie Elizabeth Ballentine, MS

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1861166381
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4388 Issued in MN
Practice address
475 Cleveland Ave N Ste 316
Saint Paul, MN 55104-5051
Phone
(651) 330-3434
NPI assigned
Aug 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4388 MN Primary

Addresses

Primary practice location

475 Cleveland Ave N Ste 316
Saint Paul, MN 55104-5051

Mailing address

475 Cleveland Ave N Ste 316
Saint Paul, MN 55104-5051
Phone (651) 330-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260507001509 MN Practitioner - Marriage and Family Therapist 3274001201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Park Ave Unit
Suite 110
Minneapolis, MN 55415-1180

475 Cleveland Ave N
Suite 316
Saint Paul, MN 55104-5051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4388MNMDMarriage & Family Therapist

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": "1628294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1861166381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CLEVELAND AVE N STE 316",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045051",
            "telephone_number": "651-330-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 CLEVELAND AVE N STE 316",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045051",
            "telephone_number": "651-330-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENTINE",
        "first_name": "KELSIE",
        "middle_name": "ELIZABETH",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-07",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.