Amy L. Kephart, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28099 Issued in MN

Practice address

3033 Excelsior Blvd Ste 215
Minneapolis, MN 55416-5274

Phone

(347) 746-0522

Fax

(651) 925-0427

NPI assigned

Feb 18, 2010

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

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Group practices

Lyn-Lake Psychotherapy and Wellness LTDGroup PAC ID 9638581291, 72 clinicians

Practice addresses (Care Compare)

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.

• Lyn-Lake Psychotherapy and Wellness LTD.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1609355163
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1174845119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 UPTON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102246",
            "telephone_number": "347-746-0522",
            "fax_number": "651-925-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 215",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554165274",
            "telephone_number": "347-746-0522",
            "fax_number": "651-925-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPHART",
        "first_name": "AMY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenwood Therapy Center, LLC
• Alexander Nicholas Kenyon-Johnson, DO
• Natalie J Kenyon, MSW, LICSW
• Susan Alexandra Kenzie, DO
• Ann Elizabeth Keogan, CRNA
• Kelsi A. Kephart, OTR/L
• Kenneth N Kephart, MD
• Philip John Keple, LPN
• Timothy Keple, MSW, LICSW
• Bethany Grace Kepler, B.S.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 22, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.