Individual provider Active NPI

Laura McKee Welp, LICSW, LADC

  • Clinical Social Worker
  • Stillwater, MN
National Provider Identifier
1114468246
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017654 Issued in IL
Practice address
1715 Tower Dr W Ste 100
Stillwater, MN 55082-7609
Phone
(651) 390-5001
Fax
(651) 390-5002
NPI assigned
Mar 8, 2017
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 31156 IL
Clinical Social Worker 1041C0700X 28599 MN
Clinical Social Worker 1041C0700X 149.017654 IL Primary

Addresses

Primary practice location

1715 Tower Dr W Ste 100
Stillwater, MN 55082-7609

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

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
I20221101003126 MN Practitioner - Clinical Social Worker 6305213562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

1715 Tower Dr W
Suite 100
Stillwater, MN 55082-7609
Phone (651) 390-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31156ILMDAddiction (Substance Use Disorder) Counselor
149.017654ILMDClinical Social Worker
28599MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Corner Counseling Current Accepting new patients
Nystrom & Associates, LTD Clinical CurrentSince Sep 19, 2022 Accepting new patients

Locations

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1715 Tower Dr W
Ste 100
Stillwater, MN 55082
Phone (651) 275-4180

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1114468246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 TOWER DR W STE 100",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827609",
            "telephone_number": "651-390-5001",
            "fax_number": "651-390-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELP",
        "first_name": "LAURA",
        "middle_name": "MCKEE",
        "credential": "LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "31156",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28599",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.