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

Active since April 05, 2018PECOS Enrolled
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: October 25, 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.

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
Phone(320) 235-4613
Sole ProprietorNo
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
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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)

Ms. Kathleen Joleen Herzog Ma, Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Kathleen Herzog reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Woodland Centers
Same address
Mental Health (Including Community Mental Health Center)
1125 6TH ST SE
Willmar, MN 56201
  • Reassigned Medicare billing, Minnesota enrollment
  • 54 clinicians in this Medicare group
NPI 1295818862 (320) 235-4613

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 20

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

BECCA WARNE
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
CATHERINE LOUCILE MOUDRY LMFT
Marriage & Family Therapist
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
TAYLOR MADSEN
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
DAVID ANTHONY MUNSON LICSW
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
HEIDI WINTER LICSW
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
DR. JULIE ANNE PATTEN PSY. D., LP
Psychologist (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
KRISTIN ASHLIE STATEN HALL LCSW
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 235-4613
EMILY ABBIGAIL MOLENAAR LICSW
Social Worker (Clinical)
1125 6TH ST SE
WILLMAR, MN 56201
Kandiyohi County (320) 894-9788

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 Kathleen Herzog's NPI number?

The NPI number for Kathleen Herzog is 1558867614. It was assigned to this individual provider in the NPPES registry on April 5, 2018.

Where is Kathleen Herzog located?

Kathleen Herzog practices at 1125 6th St SE, Willmar, MN 56201. The listed phone number is (320) 235-4613.

What is Kathleen Herzog's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kathleen Herzog enrolled in Medicare?

Yes. Kathleen Herzog is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kathleen Herzog's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Herzog reassigns Medicare benefits to Woodland Centers (Willmar, MN). 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 Kathleen Herzog'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 Kathleen Herzog was last updated on April 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.