Individual provider Active NPI

Kelly Harding

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1033912563
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23038 Issued in MN
Practice address
4344 Nicollet Ave
Minneapolis, MN 55409-2033
Phone
(612) 284-4291
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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 23038 MN Primary

Addresses

Primary practice location

4344 Nicollet Ave
Minneapolis, MN 55409-2033

Mailing address

4500 Park Glen Rd Ste 155
Saint Louis Park, MN 55416-4888
Phone (612) 284-4291

Other practice location 1

3252 Bryant Ave S
Minneapolis, MN 55408-3607
Phone (612) 284-4291

Other practice location 2

3432 Lyndale Ave S
Minneapolis, MN 55408-4151
Phone (612) 284-4291

Other practice location 3

4500 Park Glen Rd Ste 155
Saint Louis Park, MN 55416-4888
Phone (612) 284-4291

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
I20250710000852 MN Practitioner - Clinical Social Worker 6305350315 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23038MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ashlee Secord CurrentSince Jun 1, 2025 Accepting new patients
Cedar Hill Therapy, LLC Clinical PastSince Apr 6, 2025 Accepting new patients

Locations

11990 Portland Ave
Burnsville, MN 55337
Phone (612) 439-1100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1033912563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD STE 155",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554164888",
            "telephone_number": "612-284-4291",
            "fax_number": "888-975-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554092033",
            "telephone_number": "612-284-4291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3252 Bryant Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554083607",
            "country_code": "US",
            "telephone_number": "612-284-4291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3432 Lyndale Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084151",
            "country_code": "US",
            "telephone_number": "612-284-4291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4500 Park Glen Rd Ste 155",
            "address_purpose": "LOCATION",
            "city": "Saint Louis Park",
            "state": "MN",
            "postal_code": "554164888",
            "country_code": "US",
            "telephone_number": "612-284-4291",
            "fax_number": "888-975-8939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDING",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.