Cassandra Lee Kotnik, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19965 Issued in MN

Practice address

624 13TH St S
Virginia, MN 55792-3149

Phone

(218) 749-2881

Fax

(218) 749-3806

NPI assigned

Oct 12, 2018

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

• Cassandra Lee Viele Former name

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Range Mental Health CenterGroup PAC ID 3173434628, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Range Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Virginia, MN
  • NPI 1457452823
  Medicare reassignment Care Compare group NPD
• Range Mental Health Center Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Virginia, MN
  • NPI 1770872491
  NPD (past)

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1295200624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557921188",
            "telephone_number": "218-749-2881",
            "fax_number": "218-749-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 13TH ST S",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557923149",
            "telephone_number": "218-749-2881",
            "fax_number": "218-749-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTNIK",
        "first_name": "CASSANDRA",
        "middle_name": "LEE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "VIELE",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karlie J Kintner
• Jason E Kirk
• Jordan Lindsey Kitch
• Lynette Corrine Klos, CRNA
• Jennifer Lynn Kober
• Janice S Krebsbach Florey, MSW LICSW
• Alison Mary Kubat, DPT
• Megan M Kumpula
• Jessica Lahti
• Lakeview Residence

• Clinical Social Worker in Virginia, MN
• Providers in Virginia, 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 Oct 12, 2018; 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.