Caitlin Rose Tharaldson, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22855 Issued in MN

Practice address

209 Snelling Ave N
Saint Paul, MN 55104-6326

Phone

(435) 674-9310

Fax

(435) 674-9309

NPI assigned

Apr 26, 2016

Last updated

Dec 16, 2024By the provider in NPPES

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

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virta Therapy Collective LLCGroup PAC ID 7618418260, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Virta Therapy Collective LLC

  dba Virta Therapy Collective

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1477307890
  Medicare reassignment Care Compare group NPD Authorized official
• Second Nature Entrada LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Clara, UT
  • NPI 1063692804
  NPD (past)

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1275988305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SNELLING AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 SNELLING AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046326",
            "telephone_number": "435-674-9310",
            "fax_number": "435-674-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARALDSON",
        "first_name": "CAITLIN",
        "middle_name": "ROSE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheng Thao
• Soua Thao
• Sue Thao
• Titania Thao
• Vinas Thao
• Evan D Tharaldson, BA LADC
• Mary Tharaldson, EX PHYS
• Evan Thatch, LMT
• Hser Nei Thaung
• Dominique Thaxton

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 Dec 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.