MS. KATHLEEN JOLEEN HERZOG MA, LPCC
NPI 1558867614
Counselor - Professional in Willmar, MN

Active since April 05, 2018PECOS EnrolledAccepts Medicare Assignment
1125 6TH ST SE, WILLMAR, MN 56201(320) 235-4613 Get Directions Write a Review

NPPES record last updated: April 5, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Kathleen Joleen Herzog Ma, Lpcc NPPES

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

MS. KATHLEEN JOLEEN HERZOG MA, LPCC (NPI 1558867614) is an individual professional provider in Willmar, Minnesota, licensed in Minnesota (1776) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1558867614
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. KATHLEEN JOLEEN HERZOGCredential: MA, LPCC
Location Address1125 6TH ST SEWillmar, MN 56201-4675
Mailing Address413 E 4th StLitchfield, MN 55355-2208 · (320) 221-2411
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 5, 2018
NPI 1558867614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in MN · 1776
1125 6TH ST SE, Willmar, MN 56201

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Kathleen Joleen Herzog Ma, Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911357108
PECOS Enrollment IDI20240101000004
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.

Other Providers at the Same Location NPPES 20

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

Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Marriage & Family Therapist
1125 6TH ST SE
WILLMAR, MN 56201
Marriage & Family Therapist
1125 6TH ST SE
WILLMAR, MN 56201
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Counselor (Professional)
1125 6TH ST SE
WILLMAR, MN 56201
Psychologist
1125 6TH ST SE
WILLMAR, MN 56201
Counselor (Addiction (Substance Use Disorder))
1125 6TH ST SE
WILLMAR, MN 56201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558867614, enumerated as an "individual" on April 05, 2018.

The provider is located at 1125 6TH ST SE WILLMAR, MN 56201 and the phone number is (320) 235-4613.

Counselor with taxonomy code 101YP2500X and a focus in Professional.