Individual provider Active NPI

Kathryn Lund, MSW, LICSW

  • Clinical Social Worker
  • Northfield, MN
National Provider Identifier
1033791033
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28306 Issued in MN
Practice address
570 Professional Dr
Northfield, MN 55057-2756
Phone
(507) 581-8248
NPI assigned
Apr 28, 2021
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 28306 MN Primary

Addresses

Primary practice location

570 Professional Dr
Northfield, MN 55057-2756

Mailing address

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 581-8248

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211008001407 MN Practitioner - Clinical Social Worker 9638577448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Secure Base Counseling Center LLCGroup PAC ID 8628409299, 22 clinicians

Practice addresses (Care Compare)

570 Professional Dr
Northfield, MN 55057-2756
Phone (507) 301-3412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Secure Base Counseling Center LLC Clinical CurrentSince Jul 1, 2021 Accepting new patients

Locations

301 Main St E
New Prague, MN 56071
Phone (612) 758-4431

570 Professional Dr
Northfield, MN 55057
Phone (507) 301-3412

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1033791033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756",
            "telephone_number": "507-581-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572756",
            "telephone_number": "507-581-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUND",
        "first_name": "KATHRYN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, MN

Sources for this page

Verify at the official NPI Registry.