Kristen Pearl Kearns, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC02299 Issued in MN

Practice address

6363 France Ave S Ste 200
Edina, MN 55435-2140

Phone

(612) 868-9849

NPI assigned

Dec 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1912545625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352140",
            "telephone_number": "612-868-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6363 FRANCE AVE S STE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352140",
            "telephone_number": "612-868-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "KRISTEN",
        "middle_name": "PEARL",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC02299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylen Jackson Nutrition LLC
• William M Kaylor Jr., MD
• Mumtaz Kazim, M.D.
• KC Core MN PLLC
• John Robert Kearns, M.D.
• Brian Todd Keasling, ATC
• Maria Andersen Keeler
• Nicole Ann Keen, LICSW
• Kaitlin M Keeney
• Simon Keepers

• Mental Health Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.

Verify at the official NPI Registry.