Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kellan Vencil

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1083143655

Kellan Vencil is a Mental Health Counselor in Andover, Minnesota. Qualified in 2018, 8 years ago. Practices with Rum River Counseling, Inc, a 20-clinician group and accepts Medicare assignment. Licensed in Minnesota and Nebraska.

Years since qualifying
8
Licensed in
MN, NE
In the registry since
2017
Specialties on file
2

Practice location Address checks out

1875 Station Pkwy NW
Andover, MN 55304-3319
Phone: (763) 482-9598
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence CC02700 (MN)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence P-1400 (NE)

Record details

NPI number1083143655
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 7, 2017
Last updated in NPPESJuly 15, 2022
Certification dateJuly 15, 2022
Mailing address1875 Station Pkwy Nw, Andover, MN 55304-3319

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Rum River Counseling, Inc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Andover