Individual provider · Type 1 NPI

Kelly Simon

Mental Health Counselor · Maple Grove, MN

NPI number 1164916151 Active

Practice location

12918 63rd Ave N
Maple Grove, MN 55369-6001

Call (612) 554-3737 Map

Mailing address

4624 Deerwood Dr
Minnetonka, MN 55343-8679

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1164916151

Kelly Simon's National Provider Identifier is 1164916151, issued on Jun 21, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Maple Grove, MN. The record was last updated on Jan 8, 2026.