Individual provider Active NPI

Emily Elizabeth Kyllonen, MSED, LPCC

  • Professional Counselor
  • Aitkin, MN
National Provider Identifier
1891364295
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
02863 Issued in MN
Practice address
204 2ND St NW
Aitkin, MN 56431-1226
Phone
(218) 429-0105
Fax
(218) 429-0209
NPI assigned
Jun 21, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 02863 MN Primary

Addresses

Primary practice location

204 2ND St NW
Aitkin, MN 56431-1226

Mailing address

37966 390TH St
Aitkin, MN 56431-4065
Phone (218) 341-5226

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
02863MNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1891364295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37966 390TH ST",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564314065",
            "telephone_number": "218-341-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 2ND ST NW",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564311226",
            "telephone_number": "218-429-0105",
            "fax_number": "218-429-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLLONEN",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "credential": "MSED, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aitkin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.