Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Killy Kitzmann, LADC, LPC-IT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1063244952

Killy Kitzmann, LADC, LPC-IT is a Mental Health Counselor in Eden Prairie, Minnesota. Qualified in 2024, 2 years ago. Licensed in Minnesota and Wisconsin.

Years since qualifying
2
Licensed in
MN, WI
In the registry since
2024
Specialties on file
2
What do these letters mean?
LADC — Licensed Alcohol and Drug Counselor
A licensed addiction counsellor.

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Practice location Address checks out

6640 Shady Oak Rd Ste 401
Eden Prairie, MN 55344-7834
Phone: (715) 256-7166
Fax: (888) 427-8048
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 8849-226 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 307059 (MN)

Record details

NPI number1063244952
Entity typeIndividual (Type 1)
GenderMale
Credentials LADC , LPC-IT
Sole proprietorNo
NPI enumeratedAugust 19, 2024
Last updated in NPPESJanuary 14, 2026
Certification dateJanuary 14, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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