KILLY KITZMANN LADC, LPC-IT
NPI 1063244952
Counselor - Mental Health in Eden Prairie, MN

Q: What is Killy Kitzmann's NPI number?

The NPI number for Killy Kitzmann is 1063244952. It was assigned to this individual provider in the NPPES registry on August 19, 2024.

Q: What is Killy Kitzmann's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Killy Kitzmann was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 19, 2024PECOS Enrolled

6640 SHADY OAK RD STE 401, EDEN PRAIRIE, MN 55344(715) 256-7166(888) 427-8048 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 14, 2026, Sep 11, 2024, Aug 19, 2024 (3 updates tracked since 2024).

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About Killy Kitzmann Ladc, Lpc-it NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KILLY KITZMANN LADC, LPC-IT (NPI 1063244952) is an individual mental health provider in Eden Prairie, Minnesota, licensed in Wisconsin (8849-226) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1063244952

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameKILLY KITZMANNCredential: LADC, LPC-IT

Location Address6640 SHADY OAK RD STE 401Eden Prairie, MN 55344-7834

Mailing Address800 Wilson Ave Rm 330Menomonie, WI 54751-2746 · (715) 256-7166 · Fax (888) 427-8048

Phone(715) 256-7166

Fax(888) 427-8048

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 19, 2024

Last NPPES UpdateJanuary 14, 20263 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2026

✔ NPI 1063244952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in WI · 8849-226

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 307059 (MN)

6640 SHADY OAK RD STE 401, Eden Prairie, MN 55344

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Killy Kitzmann Ladc, Lpc-it is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880178052

PECOS Enrollment IDI20260325002940

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Killy Kitzmann reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thrive Psychological And Consulting Services LLC

73 mi

Professional

800 WILSON AVE RM 330
Menomonie, WI 54751

Reassigned Medicare billing, Wisconsin enrollment
26 clinicians in this Medicare group

NPI 1487383808 (715) 256-7166

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABBIE LUPELOW

Counselor (Mental Health)

6640 SHADY OAK RD STE 401
EDEN PRAIRIE, MN 55344

Hennepin County (715) 256-7166

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Killy Kitzmann's NPI number?

The NPI number for Killy Kitzmann is 1063244952. It was assigned to this individual provider in the NPPES registry on August 19, 2024.

Where is Killy Kitzmann located?

Killy Kitzmann practices at 6640 Shady Oak Rd Ste 401, Eden Prairie, MN 55344. The listed phone number is (715) 256-7166.

What is Killy Kitzmann's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Killy Kitzmann enrolled in Medicare?

Yes. Killy Kitzmann is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Killy Kitzmann's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Killy Kitzmann reassigns Medicare benefits to Thrive Psychological And Consulting Services LLC (Menomonie, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Killy Kitzmann's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Killy Kitzmann was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.