MARY KELLY KIRK-WILLENBRING MA, LPCC
NPI 1649939695
Counselor - Professional in Minneapolis, MN

Q: What is Mary Kirk-willenbring's NPI number?

The NPI number for Mary Kirk-willenbring is 1649939695. It was assigned to this individual provider in the NPPES registry on December 16, 2021.

Q: What is Mary Kirk-willenbring's specialty?

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

Active since December 16, 2021PECOS EnrolledAccepts Medicare Assignment

1915 LYNDALE AVE S, MINNEAPOLIS, MN 55403(800) 336-5973(612) 234-4689 Get Directions Write a Review

NPPES record last updated: September 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mary Kelly Kirk-willenbring Ma, Lpcc NPPES

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

MARY KELLY KIRK-WILLENBRING MA, LPCC (NPI 1649939695) is an individual professional provider in Minneapolis, Minnesota, licensed in Minnesota (CC03021) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1649939695

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMARY KELLY KIRK-WILLENBRINGCredential: MA, LPCC

Location Address1915 LYNDALE AVE SMinneapolis, MN 55403-3104

Mailing Address1915 Juliet AveSaint Paul, MN 55105-1710 · (612) 860-7566

Phone(800) 336-5973

Fax(612) 234-4689

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateDecember 16, 2021

Last NPPES UpdateSeptember 29, 2025

NPPES CertifiedSeptember 29, 2025

✔ NPI 1649939695 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 · CC03021

1915 LYNDALE AVE S, Minneapolis, MN 55403

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Secondary Practice Location 1

Location 1726 2nd St NE Ste 1Minneapolis, MN 55413-1649 · Phone (612) 704-0006

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

Mary Kelly Kirk-willenbring 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 ID5597252544

PECOS Enrollment IDI20251014002977

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 16

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

WARD STILES MA, LPCC

Counselor (Professional)