Organization Active NPI

Family Circle Counseling PLLC

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1912098070
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
03599 Issued in MN
Legal business name
FAMILY CIRCLE COUNSELING PLLC
Practice address
348 Prior Ave N
Saint Paul, MN 55104-5187
Phone
(651) 646-1488
Fax
(651) 646-2285
NPI assigned
Sep 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Krista Maria Nelson, LICSW, LMFTNPI 1760579734
Title
Chief Managing Officer
Phone
(651) 646-1488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 03599 MN Primary

Addresses

Primary practice location

348 Prior Ave N
Saint Paul, MN 55104-5187

Mailing address

348 Prior Ave N
Saint Paul, MN 55104-5187
Phone (651) 646-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000013 MN Part B Supplier - Clinic/Group Practice 4183624505 Receives reassigned benefits from 3 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

2356 University Ave W
Ste 280
Saint Paul, MN 55114
Phone (612) 207-8935

348 Prior Ave N
Saint Paul, MN 55104
Phone (651) 226-4704

348 Prior Ave N
Ste 206
Saint Paul, MN 55104
Phone (651) 646-1488

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912098070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 PRIOR AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045187",
            "telephone_number": "651-646-1488",
            "fax_number": "651-646-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 PRIOR AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045187",
            "telephone_number": "651-646-1488",
            "fax_number": "651-646-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CIRCLE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "CHIEF MANAGING OFFICER",
        "authorized_official_telephone_number": "651-646-1488",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW, LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "03599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.