Stephanie Kaitlyn Philyaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27138 Issued in MN

Practice address

603 Bruce St
Crookston, MN 56716-2914

Phone

(218) 281-3940

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 2021By 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

• Stephanie Kaitlyn Romska Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1144999137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILYAW",
        "first_name": "STEPHANIE",
        "middle_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CredibleBH.com",
            "affiliation": "N",
            "endpointDescription": "online HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "603 Bruce St",
            "city": "Crookston",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567162914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ROMSKA",
            "middle_name": "KAITLYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vinita J Parikh, MD
• Rosalene Marie Pazdernik
• Kaitlyn Perrone, LADC
• Amber Marie Peterson
• David C Peterson, DPM
• Polk County Auditor (Polk County Public Health)
• Polk County Social Services
• Polk-Norman-Mahnomen Community Health Board
• Prairie Psychological Services PA
• Breanna J. Privratsky, PA-C

• Clinical Social Worker in Crookston, MN
• Providers in Crookston, 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 Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.