Individual provider Active NPI

Kelly Jean Rokus, LPCC

  • Mental Health Counselor
  • Winona, MN
National Provider Identifier
1942718028
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC01721
Practice address
50 W 2ND St Ste 103
Winona, MN 55987-3440
Phone
(507) 312-9383
NPI assigned
Jan 11, 2018
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC01721 MN
Mental Health Counselor 101YM0800X CC01721 Primary

Addresses

Primary practice location

50 W 2ND St Ste 103
Winona, MN 55987-3440

Mailing address

50 W 2ND St Ste 103
Winona, MN 55987-3440
Phone (507) 312-9383

Other names 1

  • Kelly Jean Mouse Former name

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
I20240118002491 MN Practitioner - Mental Health Counselor 3971951591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

50 W 2ND St
Suite 103
Winona, MN 55987-3440
Phone (507) 312-9383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC01721MNMDProfessional Counselor
1721MNMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Wellness LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

50 W 2nd St
Ste 103
Winona, MN 55987
Phone (507) 312-9383

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": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1942718028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W 2ND ST STE 103",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873440",
            "telephone_number": "507-312-9383",
            "fax_number": "507-229-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W 2ND ST STE 103",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873440",
            "telephone_number": "507-312-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROKUS",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC01721",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "CC01721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MOUSE",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.