Individual provider Active NPI

PA Kou Yang

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1053158782
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30586 Issued in MN
Practice address
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone
(651) 280-2310
Fax
(651) 280-3995
NPI assigned
Jul 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 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 30586 MN Primary

Addresses

Primary practice location

451 Lexington Pkwy N
Saint Paul, MN 55104-4636

Mailing address

451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone (651) 280-2310

Other practice location 1

5555 Boone Ave N
New Hope, MN 55428-3636
Phone (651) 774-0011

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
I20240729003835 MN Practitioner - Clinical Social Worker 7810433604 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Akv Psychological and Consulting Services LLCGroup PAC ID 6608932272, 4 clinicians

Practice addresses (Care Compare)

2165 Woodlane Dr
Suite 100
Woodbury, MN 55125-3055
Phone (651) 283-3794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30586MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
People Incorporated CurrentSince Nov 3, 2025 Accepting new patients
Amherst H. Wilder Foundation CurrentSince Jul 8, 2024 Accepting new patients
People Incorporated Current Accepting new patients
Be Well Psychological Services, LLC CurrentSince Sep 23, 2024 Accepting new patients
Akv Psychological and Consulting Services, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

2120 Park Ave
Minneapolis, MN 55404
Phone (612) 872-2000

1930 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 427-7964

5555 Boone Ave N
New Hope, MN 55428
Phone (763) 331-3033

3000 Ames Crossing Rd
Ste 600
Saint Paul, MN 55121
Phone (651) 288-3467

317 York Ave
Saint Paul, MN 55130
Phone (651) 771-0286

2165 Woodlane Dr
Ste 100
Woodbury, MN 55125
Phone (612) 234-1558

Organizations & group practices 5

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": "1720569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1053158782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2310",
            "fax_number": "651-280-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2310",
            "fax_number": "651-280-3995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Boone Ave N",
            "address_purpose": "LOCATION",
            "city": "New Hope",
            "state": "MN",
            "postal_code": "554283636",
            "country_code": "US",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "PA KOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-10",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.