Katherine Rose Haberkorn, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19228 Issued in MN

Practice address

13045 Falcon Dr Ste 100
Baxter, MN 56425-4201

Phone

(218) 829-9307

Fax

(218) 829-7649

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Health SystemGroup PAC ID 1052229671, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakewood Health System

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1013401546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13045 FALCON DR STE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564254201",
            "telephone_number": "218-829-9307",
            "fax_number": "218-829-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERKORN",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Gundlach, CCC-SLP
• Lori A Gutierrez, WHCNP
• Bridget Lee Lynn Gutknecht
• Dana Gutzmann, PTA
• Britne Haasch, LICSW
• Susan J Hadland, NP
• Andrew Richard Hadrich, DPT
• Melissa Carol Hagberg, RDH
• Nicolle Hagen, APRN
• Lori Hagood, PT, CHT

• Clinical Social Worker in Baxter, MN
• Providers in Baxter, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.