Individual provider Active NPI

Sarah Marie Kyalo, LICSW

  • Clinical Social Worker
  • Bloomington, MN
National Provider Identifier
1215891122
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19334 Issued in MN
Practice address
4617 Oxborough LN
Bloomington, MN 55437-3213
Phone
(612) 987-7898
NPI assigned
Dec 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 19334 MN Primary

Addresses

Primary practice location

4617 Oxborough LN
Bloomington, MN 55437-3213

Mailing address

4617 Oxborough LN
Bloomington, MN 55437-3213
Phone (612) 987-7898

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260520001525 MN Practitioner - Clinical Social Worker 8123597077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orka Health and Wellness PLLCGroup PAC ID 9830595545, 8 clinicians

Practice addresses (Care Compare)

6804 Iroquois Cir
Edina, MN 55439-1014
Phone (612) 564-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19334MNMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1215891122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 OXBOROUGH LN",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554373213",
            "telephone_number": "612-987-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 OXBOROUGH LN",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554373213",
            "telephone_number": "612-987-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYALO",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.