Individual provider Active NPI

Kathleen Sue Flynn Higby, MSSW, LICSW

  • Clinical Social Worker
  • New Brighton, MN
National Provider Identifier
1255358834
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5945 Issued in MN
Practice address
1900 Silver Lake Rd NW
Suite110
New Brighton, MN 55112-1786
Phone
(651) 628-9566
Fax
(651) 628-0411
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5945 MN Primary

Addresses

Primary practice location

1900 Silver Lake Rd NW
Suite110
New Brighton, MN 55112-1786

Mailing address

1900 Silver Lake Rd NW
Suite110
New Brighton, MN 55112-1786
Phone (651) 628-9566

Other names 1

  • Kathleen Sue Flynn Former name

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
I20161206000505 MN Practitioner - Clinical Social Worker 6507146727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical CurrentSince Nov 2, 2016 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255358834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN HIGBY",
        "first_name": "KATHLEEN",
        "middle_name": "SUE",
        "credential": "MSSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "5945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "FLYNN",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.