Katie Marie Onofreychuk, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19424 Issued in MN

Practice address

1401 East 1St Street
Duluth, MN 55805-2407

Phone

(218) 728-4491

Fax

(218) 730-2367

NPI assigned

Apr 26, 2016

Last updated

Sep 30, 2019By 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

Other names 1

• Katie Marie Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

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.

• Brightwater Health Dba Human Development Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1194790733
  NPD
• Brightwater Health Dba Human Development Center

  • Community/Behavioral Health Agency
  • Cloquet, MN
  • NPI 1114048527
  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": "1569801600000",
    "number": "1295180479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAST 1ST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 EAST 1ST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052147",
            "country_code": "US",
            "telephone_number": "218-728-3931",
            "fax_number": "218-302-8728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161300",
            "country_code": "US",
            "telephone_number": "218-834-5520",
            "fax_number": "218-834-4264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1406 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052378",
            "country_code": "US",
            "telephone_number": "218-624-5683",
            "fax_number": "218-624-5736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 11th St",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "557201817",
            "country_code": "US",
            "telephone_number": "218-879-4559",
            "fax_number": "218-879-0282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONOFREYCHUK",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "JOHNSON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wendy Michelle Olson, LICSW
• Itunu Olukoga
• Omnia Wellness and Recovery
• Emily C. Onello, MD
• Amy C Onken, O.D.
• Op Orthodontics of Minnesota PLLC (Carlson Orthodontics)
• Emily Rose Opacich, RN, CNP
• Open Sky Therapy and Wellness LLC
• Thomas Opheim, M.D.
• Tigist Opheim, PA-C

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, 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 Sep 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.