Individual provider Active NPI

Kerri C Klingfus, LICSW

  • Clinical Social Worker
  • Mantorville, MN
National Provider Identifier
1255135380
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14031 Issued in MN
Practice address
25798 611TH St
Mantorville, MN 55955-7038
Phone
(507) 634-4969
Fax
(507) 634-4969
NPI assigned
Apr 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 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 Worker 1041C0700X 14031 MN Primary

Addresses

Primary practice location

25798 611TH St
Mantorville, MN 55955-7038

Mailing address

25798 611TH St
Mantorville, MN 55955-7038
Phone (507) 634-4969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14031MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1255135380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25798 611TH ST",
            "city": "MANTORVILLE",
            "state": "MN",
            "postal_code": "559557038",
            "telephone_number": "507-634-4969",
            "fax_number": "507-634-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25798 611TH ST",
            "city": "MANTORVILLE",
            "state": "MN",
            "postal_code": "559557038",
            "telephone_number": "507-634-4969",
            "fax_number": "507-634-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGFUS",
        "first_name": "KERRI",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mantorville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.