Deborah J Locketz, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19841 Issued in MN

Practice address

4737 County Road 101 # 175
Minnetonka, MN 55345-2634

Phone

(952) 208-6700

Fax

(952) 208-6343

NPI assigned

Jan 14, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 4, 2024 through Jan 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Relate Inc

  • Community/Behavioral Health Agency
  • Minnetonka, MN
  • NPI 1053486902
  NPD (past)

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1225502172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4737 COUNTY ROAD 101 # 175",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452634",
            "telephone_number": "952-208-6700",
            "fax_number": "952-208-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4737 COUNTY ROAD 101 # 175",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452634",
            "telephone_number": "952-208-6700",
            "fax_number": "952-208-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKETZ",
        "first_name": "DEBORAH",
        "middle_name": "J",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Liu, PHD
• Zhaotong Liu
• Live 2 B Healthy Senior Fitness, LLC
• Jessica Lloyd, PSYD, LP
• Eric Locher
• Melissa Lockwood, FNP-C
• Haley Loeffler
• Colleen A Lofgren, RDN, LD
• Adam Lokeh, M.D.
• Patricia Ann Lomnicki, RN, CNP

• Clinical Social Worker in Minnetonka, MN
• Providers in Minnetonka, 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 17, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.