Mai Khou Yang, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19519 Issued in MN

Practice address

708 W Broadway Ave Ste a
Forest Lake, MN 55025-3787

Phone

(651) 408-5154

NPI assigned

Oct 6, 2021

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1174285183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 W BROADWAY AVE STE A",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550253787",
            "telephone_number": "651-408-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W BROADWAY AVE STE A",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550253787",
            "telephone_number": "651-408-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MAI KHOU",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Clare Wolney
• Scott Russell Wood, PHARM.D.
• Patricia Woolfrey-Flatten, OTR/L
• Debra Kristen Wynia, DDS
• Sarah Elizabeth Yackley-Ploeger, D.C.
• Jennifer Marrion Youngs, CMT
• Rebecca A Zabinski, MA, LPCC
• Mikayla Zais, PT, DPT
• Scott Zieglmeier, RN
• Nichelle Rae Zimmer

• Clinical Social Worker in Forest Lake, MN
• Providers in Forest Lake, 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 Oct 20, 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.