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

Mr. Kyle William Ross, LPCC

Individual provider Mental Health Counselor · NPI 1528502598

Mr. Kyle William Ross, LPCC is a Mental Health Counselor in Spring Lake Park, Minnesota. Qualified in 2014, 12 years ago. Practices with Expanse - a Minnesota Mental Health Ketamine and Psychedelic Psychothe, a 12-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2016
What do these letters mean?
LPCC — Licensed Professional Clinical Counselor
The title some states use for a licensed clinical counsellor.

See every abbreviation used in this directory →

Practice location Address checks out

7766 Highway 65 NE
Spring Lake Park, MN 55432-2832
Phone: (763) 205-4843
Fax: (612) 416-2085
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence CC01396 (MN)

Record details

NPI number1528502598
Entity typeIndividual (Type 1)
GenderMale
Credentials LPCC
Sole proprietorNo
NPI enumeratedDecember 11, 2016
Last updated in NPPESApril 9, 2025
Certification dateApril 9, 2025
Mailing address7766 Highway 65 Ne, Spring Lake Park, MN 55432-2832

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Expanse - A Minnesota Mental Health Ketamine And Psychedelic Psychothe — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Spring Lake Park