Individual provider Active NPI

Beth Ann Kolander, LICSW

  • Clinical Social Worker
  • Owatonna, MN
National Provider Identifier
1326288267
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13491 Issued in MN
Practice address
610 Florence Ave
Owatonna, MN 55060-4704
Phone
(507) 451-2630
Fax
(507) 455-8133
NPI assigned
Mar 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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 13491 MN Primary

Addresses

Primary practice location

610 Florence Ave
Owatonna, MN 55060-4704

Mailing address

521 Pfau St
Mankato, MN 56001-7032
Phone (507) 389-6783

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address messagec@direct.schrc.com

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
I20120206000147 MN Practitioner - Clinical Social Worker 4284891102

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

610 Florence Ave
Owatonna, MN 55060-4704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13491MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1326288267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 PFAU ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017032",
            "telephone_number": "507-389-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 FLORENCE AVE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604704",
            "telephone_number": "507-451-2630",
            "fax_number": "507-455-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLANDER",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "messagec@direct.schrc.com",
            "affiliation": "N",
            "address_1": "610 Florence Ave",
            "city": "Owatonna",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550604704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.