MS. KELLY SUMMERS (NPI# 1912217480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912217480 |
| Entity Type | Individual |
| Full Name | MS. KELLY SUMMERS |
| Credential | LADC |
| Practice Address |
950 County Highway 10 108 Spring Lake Park MN 55432-1253 |
| Practice Telephone | 7633555092 |
| Mailing Telephone | 7633555092 |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302446 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455159 | Kelly Sue Summers | Technician | 1205 9th St Apt 502, Vienna, WV 26105-2158 | 2020-07-28 |
| 1023531043 | Kelly Marie Summers | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2017-07-21 |
| 1003291089 | Kelly Christine Summers | Optometrist | 10967 Allisonville Rd, Suite 120, Fishers, IN 46038-2632 | 2015-07-20 |
| 1649514423 | Kelly Elizabeth Summers | Physician Assistant | 550 Peachtree St Ne, Mot 9th Floor, Atlanta, GA 30308 | 2012-11-19 |
| 1649412875 | Kelly Summers | Counselor | 3800 Coolidge Ave, Oakland, CA 94602-3311 | 2009-04-02 |
| Street Address |
950 COUNTY HIGHWAY 10 108 |
| City | SPRING LAKE PARK |
| State | MN |
| Zip Code | 55432-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215226212 | Moving Forward Assessment Services | Community/Behavioral Health | 950 County Highway 10, 108, Spring Lake Park, MN 55432-1253 | 2011-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528619244 | Rosanna Karmoeddien | Counselor | 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2868 | 2019-09-24 |
| 1346805108 | Kristine Marie Pappone | Counselor | 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2868 | 2019-05-07 |
| 1386117257 | Evan Hascall | Counselor | 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2868 | 2019-01-03 |
| 1851863120 | Anita Raaum | Counselor | 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2868 | 2018-12-26 |
| 1558832352 | Todd Ostertag | Counselor | 7766 Highway 65 Ne, Spring Lake Park, MN 55432-2868 | 2018-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1134720212 | Rachel Renee Przekwas | Counselor | 216 Center St W Ste 101, Roseau, MN 56751-1494 | 2020-11-04 |
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1215537477 | Hannah Mae Kidder | Counselor | 1605 Welcome Ave N, Golden Valley, MN 55422-4429 | 2020-10-27 |
| 1649879339 | Jordan Lowe | Counselor | 4615 Grand Ave Ste 300, Duluth, MN 55807-2749 | 2020-10-22 |
| 1417556762 | Jacob R Poppinga | Counselor | 13045 Falcon Dr Ste 7404th, Baxter, MN 56425-4201 | 2020-10-19 |
| 1598362014 | Jeremy Krekula | Counselor | 102 Main St N Ste 100, Stewartville, MN 55976-2608 | 2020-10-07 |
| 1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
| 1952908881 | Sutton Outpatient Services, LLC | Counselor | 1700 Livingston Ave Ste 120, West St Paul, MN 55118-5938 | 2020-10-05 |
| 1750998423 | Recovery Alliance Duluth | Counselor | 206 W 4th St Ste 203, Duluth, MN 55806-2659 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | SPRING LAKE PARK |
| Zip Code | 55432 |
Please comment or provide details below to improve the information on MS. KELLY SUMMERS.
| 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.