Kelsie Jean Fuoss, BA, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

303566 Issued in MN

Practice address

266 E Bridge St
Redwood Falls, MN 56283-1664

Phone

(507) 637-4050

Fax

(507) 637-4055

NPI assigned

Jan 3, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

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.

• MBH-MN Medical Clinic PA

  • Clinic/Center
  • New Brighton, MN
  • NPI 1922586270
  NPD (past)

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1982177838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 E BRIDGE ST",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "562831664",
            "telephone_number": "507-637-6093",
            "fax_number": "507-637-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 E BRIDGE ST",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "562831664",
            "telephone_number": "507-637-4050",
            "fax_number": "507-637-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUOSS",
        "first_name": "KELSIE",
        "middle_name": "JEAN",
        "credential": "BA, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Flinn, PSYD, LP
• Michael William Flinn, DDS
• Christine Marie Forry Tauer, RN
• Joshua D. Friese, MD
• Deanie Reigh Fuhr, D.C.
• Jack Gasperlin, ATC
• Jordyn Ann Gilliland
• Amber R Green, M.S.
• Cynthia K Gronau, MD
• Thomas C. Gross, MD

• All providers in Redwood Falls, MN
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.