MS. KELLY JEAN RAVENFEATHER (NPI# 1013054642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013054642 |
| Entity Type | Individual |
| Full Name | MS. KELLY JEAN RAVENFEATHER |
| Credential | MS ED, LP, LMFT |
| Practice Address |
230 E Superior St Ste 101 Duluth MN 55802-2104 |
| Practice Telephone | 2187265433 |
| Practice Fax Number | 2182792844 |
| Mailing Telephone | 2187265433 |
| Mailing Fax Number | 2182792844 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | LP1839 | MN | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
6878 | MN | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 497 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTHPARTNERS | HP35232 | 01 |
| MN | MANAGED HEALTH NETWORK | 226395 | 01 |
| MN | MEDICA, UBH, SELECT CARE | 6235843 | 01 |
| MN | BLUECROSS BLUESHIELD | 21F85RA | 01 |
| Street Address |
230 E SUPERIOR ST STE 101 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493952 | Michelle Brownfield | Psychologist | 606 Spear Ave, Duluth, MN 55803-2154 | 2020-10-01 |
| 1770143331 | James Vincent Shreffler | Psychologist | 324 W Superior St Ste 620, Duluth, MN 55802-1723 | 2019-06-17 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1437447992 | Michelle Simon | Psychologist | 1005 W Morgan St, Duluth, MN 55811-4424 | 2011-07-19 |
| 1215161823 | Jude Martin Henningsgaard | Psychologist | 405 E Superior St, Duluth, MN 55802-2240 | 2009-05-11 |
| 1518143999 | Claudia Virginia Weber | Psychologist | 4298 Charles Rd, Duluth, MN 55803-1270 | 2008-01-15 |
| 1356486153 | Penelope Jean Gooch | Psychologist | 101 W 2nd Street, Suite 100 Northern Lights Counseling Center, Duluth, MN 55802 | 2007-02-20 |
| 1215070073 | Marcus Peter Desmonde | Psychologist | 716 Medical Arts Bldg, Duluth, MN 55802-1721 | 2007-02-14 |
| 1417009804 | Susan Ruth Hall | Psychologist | 1707 Miller Trunk Hwy, Duluth, MN 55811-1880 | 2007-01-17 |
| 1508922386 | Northwood Children's Services, Inc. | Psychologist | 1131 N 11th Ave E, Duluth, MN 55805-1517 | 2006-12-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.