Kirby Kaczor, LPCC
NPI 1003679234 · Counselor · White Bear Lake, MN
Enrolled with Medicare as Practitioner - Mental Health Counselor · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kirby Kaczor, LPCC is a Counselor provider in White Bear Lake, MN (NPI 1003679234).
Provider details
- NPI number
- 1003679234
- Entity type
- Individual
- Primary specialty
- CounselorBehavioral Health & Social Service Providers
- Credential
- LPCC
- Sex
- Male
- Sole proprietor
- No
- License
- 4263 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4432 Chicago Ave Ste 1Minneapolis, MN 55407-3521Phone: (612) 870-2454
Registry dates
- Enumerated
- 2024-01-31
- Last updated
- 2024-01-31
- Certified
- 2024-01-31
Frequently asked questions
- What is Kirby Kaczor's NPI number?
- Kirby Kaczor's National Provider Identifier (NPI) is 1003679234, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kirby Kaczor's specialty?
- Kirby Kaczor is listed in the NPPES registry with a primary specialty of Counselor (Behavioral Health & Social Service Providers).
- Where is Kirby Kaczor located?
- Kirby Kaczor's practice location on file with NPPES is 2025 4th St Ste 100, White Bear Lake, MN 55110-2875.
- What is Kirby Kaczor's phone number?
- The practice phone number listed in the NPPES registry for Kirby Kaczor is (651) 212-4920.
- Does Kirby Kaczor accept Medicare?
- Kirby Kaczor is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kirby Kaczor's NPI active?
- Yes — Kirby Kaczor's NPI (1003679234) is active in the NPPES registry as of the last update on 2024-01-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.