Ka Lo, LICSW

Individual provider Active NPI Clinical Social Worker · Saint Paul, MN

NPI 1235524950 · NPPES record last updated Mar 31, 2015

Key facts

NPI
1235524950
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
21203 (MN)
Practice address
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone
(651) 280-2310
Fax
(651) 280-3995
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amherst H. Wilder Foundation (20 clinicians)

Practice addresses (Care Compare)

451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone (651) 280-2310

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20171128000763 MN Practitioner - Clinical Social Worker 9638436728 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
21203MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amherst H. Wilder Foundation Current
since Oct 3, 2017
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21203 MN Yes

Addresses

Primary practice location

451 Lexington Pkwy N
Saint Paul, MN 55104-4636

Mailing address

451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone (651) 280-2310

Other providers in Saint Paul, MN

All providers in Saint Paul, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.