Active NPI
Lorraine Ann Knudtson, LICSW
- Clinical Social Worker
- Saint Paul, MN
National Provider Identifier
1144631656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21260
- Practice address
- 1684 Selby Ave
Saint Paul, MN 55104-6149 - Phone
- (612) 756-4983
- Fax
- (651) 234-8955
- NPI assigned
- May 19, 2014
- Last updated
- May 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21260 | MN | Primary |
Addresses
Primary practice location
1684 Selby Ave
Saint Paul, MN 55104-6149
Mailing address
660 South Freeway Road
Mendota Heights, MN 55118
Phone (612) 756-4983
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21260 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400457600000",
"number": "1144631656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 SOUTH FREEWAY ROAD",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "55118",
"telephone_number": "612-756-4983",
"fax_number": "651-234-8955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1684 SELBY AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551046149",
"telephone_number": "612-756-4983",
"fax_number": "651-234-8955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDTSON",
"first_name": "LORRAINE",
"middle_name": "ANN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-19",
"last_updated": "2014-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "21260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.