Active NPI
Kelly Fern
- Marriage & Family Therapist
- Apple Valley, MN
National Provider Identifier
1891240867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3326
- Practice address
- 15650 Cedar Ave
Apple Valley, MN 55124-7283 - Phone
- (612) 672-6999
- NPI assigned
- Aug 19, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 3326 | MN | Primary |
Addresses
Primary practice location
15650 Cedar Ave
Apple Valley, MN 55124-7283
Mailing address
1320 S Frontage Rd
Hastings, MN 55033-2684
Phone (612) 500-0905
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3933 Ewing Ave S
Minneapolis, MN 55410-1053
3947 Excelsior Blvd
Suite 110
Minneapolis, MN 55416-4779
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3326 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fern Counseling PLLC | Marriage & Family Therapist | Current | Accepting new patients |
Locations
3947 Excelsior Blvd
Ste 110
St Louis Park, MN 55416
Phone (612) 925-5776
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 and National Provider Directory roles.
-
- Marriage & Family Therapist
- Minneapolis, MN
- NPI 1790356186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1891240867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 S FRONTAGE RD",
"city": "HASTINGS",
"state": "MN",
"postal_code": "550332684",
"telephone_number": "612-500-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15650 CEDAR AVE",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247283",
"telephone_number": "612-672-6999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERN",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-19",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "3326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.