Individual provider Active NPI

Kylie Cousineau Ramaker, LICSW

  • Clinical Social Worker
  • Rochester, MN
National Provider Identifier
1326858432
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31051 Issued in MN
Practice address
4600 18TH Ave NW
Rochester, MN 55901-2116
Phone
(507) 287-2010
Fax
(507) 287-7805
NPI assigned
Jan 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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 31051 MN Primary

Addresses

Primary practice location

4600 18TH Ave NW
Rochester, MN 55901-2116

Mailing address

4600 18TH Ave NW
Rochester, MN 55901-2116
Phone (507) 287-2010

Other names 1

  • Kylie Christine Cousineau 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
I20250401001463 MN Practitioner - Clinical Social Worker 4385167238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Service Rochester IncGroup PAC ID 1759658388, 7 clinicians

Practice addresses (Care Compare)

4600 18TH Ave NW
Rochester, MN 55901-2116
Phone (507) 287-2010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31051MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Rochester, Inc CurrentSince Jan 8, 2025 Accepting new patients

Locations

4600 18th Ave NW
Rochester, MN 55901
Phone (507) 287-2010

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": "1736467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1326858432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 18TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012116",
            "telephone_number": "507-287-2010",
            "fax_number": "507-287-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 18TH AVE NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559012116",
            "telephone_number": "507-287-2010",
            "fax_number": "507-287-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAKER",
        "first_name": "KYLIE",
        "middle_name": "COUSINEAU",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "COUSINEAU",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.