Kallie Joy Bennett

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28361 Issued in MN

Practice address

14301 Ewing Ave S
Burnsville, MN 55306-4885

Phone

(952) 746-5350

NPI assigned

Apr 26, 2018

Last updated

May 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kallie Joy Trutnau Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• County of Scott

  dba Scott County Mental Health Center

  • Psychologist
  • Shakopee, MN
  • NPI 1841299443

  Single Specialty

  Medicare reassignment NPD
• County of Scott

  • Public Health or Welfare Agency
  • Shakopee, MN
  • NPI 1821156183
  NPD
• County of Scott

  • Community/Behavioral Health Agency
  • Shakopee, MN
  • NPI 1710047535
  NPD (past)

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1073001889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14301 EWING AVE S",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064885",
            "telephone_number": "952-746-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KALLIE",
        "middle_name": "JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALLIE",
            "last_name": "TRUTNAU",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dante Joseph Bender
• Lindsey Lee Bender
• Chloe Ann Bendt
• Lisa Benedetto, CNP
• Danielle Bennett, MD
• Karlynn Lee Benson, DC
• Rebecca Benson, ATC
• Gregory Lee Berglund, RPH
• Stuart Bergman-Bock, M.D.
• Gabriel Joseph Bergmann

• Clinical Social Worker in Burnsville, MN
• Providers in Burnsville, 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 May 31, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.