Kristin Ashlie Staten Hall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010776 Issued in VA

Practice address

1125 6TH St SE
Willmar, MN 56201-4675

Phone

(320) 235-4613

Fax

(855) 625-7406

NPI assigned

Feb 6, 2019

Last updated

Jun 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristin Ashlie Staten 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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Woodland Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willmar, MN
  • NPI 1295818862
  Medicare reassignment Care Compare group NPD
• Love Never Fails, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manassas, VA
  • NPI 1801422464
  NPD Authorized official

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1073078705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7343 SAINT THOMAS LOOP",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201097116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4613",
            "fax_number": "855-625-7406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7343 Saint Thomas Loop",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201097116",
            "country_code": "US",
            "telephone_number": "931-607-0151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7730 Donegan Dr",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201092868",
            "country_code": "US",
            "telephone_number": "571-208-0592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATEN HALL",
        "first_name": "KRISTIN",
        "middle_name": "ASHLIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "STATEN",
            "middle_name": "ASHLIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terry Stephen Spieker, COTA
• Stadther Chiropractic, LTD (Meridian Disc Institute)
• Whitney Stadther
• Amanda Stangel, MS
• Shelly M Staska, MD
• Kaleena Steinberg
• Katherine Marie Steinhoff, LICSW
• Stephen J. Reigstad Optometry Inc. (Stephen's Downtown Optical)
• Matthew Stephens, HID
• Roger Curtis Stephens

• Clinical Social Worker in Willmar, MN
• Providers in Willmar, 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 Jun 24, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.