Individual provider Active NPI

Charles Redmond Kane, MS, LPCC

  • Professional Counselor
  • Maple Grove, MN
National Provider Identifier
1982570255
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5256 Issued in MN
Practice address
7767 Elm Creek Blvd N Ste 220
Maple Grove, MN 55369-7067
Phone
(651) 313-8080
NPI assigned
Oct 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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 5256 MN Primary

Addresses

Primary practice location

7767 Elm Creek Blvd N Ste 220
Maple Grove, MN 55369-7067

Mailing address

7767 Elm Creek Blvd N Ste 220
Maple Grove, MN 55369-7067
Phone (651) 313-8080

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
I20251118002167 MN Practitioner - Mental Health Counselor 2466943477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1370 Mendota Heights Rd
Mendota Heights, MN 55120-1128

13890 McKenna Rd NW
Prior Lake, MN 55379-7537

7101 York Ave S
Suite 317
Edina, MN 55435-4469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5256MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie Family Services, PLLP CurrentSince Nov 1, 2025 Accepting new patients
Nystrom & Associates, LTD CurrentSince Apr 13, 2026 Accepting new patients
Stacia Hanson Ma LP LLC CurrentSince Dec 22, 2025 Accepting new patients

Locations

7767 Elm Creek Blvd N
Ste 220
Maple Grove, MN 55369
Phone (612) 516-5660

7767 Elm Creek Blvd N
Ste 220240
Maple Grove, MN 55369

7101 York Ave S
Ste 317
Minneapolis, MN 55435
Phone (763) 703-4207

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080

1197 Grand Ave
Saint Paul, MN 55105
Phone (763) 703-4215

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1982570255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7767 ELM CREEK BLVD N STE 220",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697067",
            "telephone_number": "651-313-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7767 ELM CREEK BLVD N STE 220",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697067",
            "telephone_number": "651-313-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "CHARLES",
        "middle_name": "REDMOND",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "5256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.