Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1851923445 Individual Practitioner Male Practitioner

Kyle Johannessen , LPCC

Counselor - Professional • Coon Rapids, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kyle Johannessen, LPCC is a certified Counselor - Professional practicing in Coon Rapids, MN. With approximately 10 years of clinical experience since completing medical education in 2016, Kyle Johannessen delivers high-quality medical care to the local community at 9120 SPRINGBROOK DR NW.

Kyle Johannessen is affiliated with Fraser Child And Family Center and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

9120 Springbrook Dr Nw

Coon Rapids, MN 554335845

Telephone 6127677222

Medicare Profile & Education

Medical School

Other

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Coon Rapids, MN

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
10 Yrs -0.8 yrs vs City Avg
City Avg: 10.8 Yrs
State Avg: 11.4 Yrs
Regional Practice Density
31 Specialists

Practicing in Coon Rapids, MN (2422 Statewide)

Telehealth Adoption Rate
19.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Johannessen (10 Years) 10 Yrs
Coon Rapids Specialty Average (10.8 Years) 10.8 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-09-05
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MN CC02342

Definition to come...

Hospital & Practice Group Affiliations

Fraser Child And Family Center

2400 W 64th St, Richfield, MN 554231001

Phone: 6128611688

Fraser Child And Family Center

9120 Springbrook Dr Nw, Coon Rapids, MN 554335845

Phone: 6127677222

Secondary Practice Locations

4849 Ivanhoe St

Duluth, MN 558041131

Phone: 2187287418

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Anna Schulz , MS, BCBA

Behavior Analyst

NPI 1003452632

Master of Science, Board Certified Behavior Analyst

Sarah Lynch , MS, BCBA

Behavior Analyst

NPI 1003459835

Master of Science, Board Certified Behavior Analyst

Mystic Makepeace

Behavior Technician

NPI 1003486564
Khaleda Islam

Behavior Technician

NPI 1003549676
Melissa Becerra

Behavior Technician

NPI 1003592650
Nimco Salah

Behavior Technician

NPI 1003742594

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location September 05, 2024

Registered at 9120 SPRINGBROOK DR NW, COON RAPIDS, MN 554335845 (Tel: 6127677222)

📍
Updated Business Mailing Address September 05, 2024

Registered at 9120 SPRINGBROOK DR NW, COON RAPIDS, MN 554335845 (Tel: 6127677222)

NPI Profile Active February 11, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location February 11, 2020

Registered at 4849 IVANHOE ST, DULUTH, MN 558041131 (Tel: 2187287418)

📍
Updated Business Mailing Address February 11, 2020

Registered at 4321 ALLENDALE AVE, DULUTH, MN 558031562 (Tel: 2187287500)

👤
Provider Name / Credentials Updated February 11, 2020

Recorded as KYLE JOHANNESSEN, LPCC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2020

Counselor (License #CC02342 in MN)

🟢
Initial NPI Registration & Enumeration February 11, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851923445
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 11, 2020
Last Update: September 05, 2024
Sole Proprietor: No

Mailing Address

9120 Springbrook Dr Nw

Coon Rapids, MN 554335845

Phone: 6127677222

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.