Wyatt Coleman

Individual provider Active NPI Clinical Social Worker · Afton, MN

NPI 1164095568 · NPPES record last updated Sep 15, 2025

Key facts

NPI
1164095568
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
27832 (MN)
Practice address
15489 45TH St S
Afton, MN 55001-9681
Phone
(651) 315-5254
Fax
(651) 300-2745
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27832MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Acres Counseling, LLC Current
since Sep 21, 2025
Accepting new patients
Washburn Center for Children Past
since Jul 1, 2021
Accepting new patients
Center for Child Abuse Prevention and Treatment Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27832 MN Yes

Addresses

Primary practice location

15489 45TH St S
Afton, MN 55001-9681

Mailing address

15489 45TH St S
Afton, MN 55001-9681
Phone (651) 315-5254

Other names

  • Katie Marie Fleckenstein Former name

Other providers in Afton, MN

All providers in Afton, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.