Individual provider Active NPI

Kathryn Solveig Christenson, LICSW

  • Clinical Social Worker
  • Edina, MN
National Provider Identifier
1063170801
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25253 Issued in MN
Practice address
6565 France Ave S Ste 402
Edina, MN 55435-2137
Phone
(952) 903-1270
Fax
(952) 922-2049
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 25253 MN Primary

Addresses

Primary practice location

6565 France Ave S Ste 402
Edina, MN 55435-2137

Mailing address

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (763) 762-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25253MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1063170801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FRANCE AVE S STE 402",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352137",
            "telephone_number": "952-903-1270",
            "fax_number": "952-922-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSON",
        "first_name": "KATHRYN",
        "middle_name": "SOLVEIG",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.