Kathryn Mary Conery, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21261 Issued in MN

Practice address

659 Bielenberg Dr
Woodbury, MN 55125-1706

Phone

(952) 903-1342

Fax

(651) 259-9770

NPI assigned

Jun 1, 2015

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

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 and National Provider Directory roles.

• Collaborative Psychiatric Services LLC

  • Psychiatry Physician
  • Oak Park Heights, MN
  • NPI 1699525857
  NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  Clinical

  NPD

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1144600503",
    "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": "659 BIELENBERG DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251706",
            "telephone_number": "952-903-1342",
            "fax_number": "651-259-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONERY",
        "first_name": "KATHRYN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Compassionate Autism Center Inc
• Comprehensive and Compassionate Care LLC
• Comprehensive Healthcare for Women, PA
• Comprehensive Solutions
• Lawrence M Condon, MD
• Kathryn Connell, DDS
• Daniel Q Connelly
• Kevin Sean Conners, D.C.
• Renee Rivera Connor
• Mikayla Conrath

• All providers in Woodbury, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.