Karla Kelpin Wise, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC03492 Issued in MN

Practice address

4105 Vera Cruz Ave N
Robbinsdale, MN 55422-1724

Phone

(763) 546-1627

NPI assigned

Mar 17, 2013

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

Other names 1

• Karla Kelpin Boemer Former name

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vantage Mental HealthGroup PAC ID 4587104815, 29 clinicians

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.

• Vantage Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park Heights, MN
  • NPI 1538990288
  Medicare reassignment Care Compare group NPD
• Sunflower Therapy Services LLC

  • Adult Mental Health Clinic/Center
  • St Anthony, MN
  • NPI 1093502098
  NPD
• Collaborative Psychiatric Services LLC

  • Psychiatry Physician
  • Oak Park Heights, MN
  • NPI 1699525857
  NPD (past)
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD (past)

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

{
    "created_epoch": "1363478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1992047948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 VERA CRUZ AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221724",
            "telephone_number": "763-546-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 VERA CRUZ AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221724",
            "telephone_number": "763-546-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KARLA",
        "middle_name": "KELPIN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLA",
            "last_name": "BOEMER",
            "middle_name": "KELPIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Wilder, PA-C
• Chase Williams
• Andrew Palmer Wilson, M.D.
• Francine Wilson, CMT
• Jordan Elizabeth Wise, DNP, APRN, CRNA
• Janette Elaine Withers, MD
• Dawn E Witthaus, LICSW
• Lynda Wolfe, APRN, CNP
• Grace L Wollschlager, DPT
• Angela Wood, PHARM.D., BCPS

• Mental Health Counselor in Robbinsdale, MN
• Providers in Robbinsdale, 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 17, 2024; 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.