Kathleen Wright, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21383 Issued in MN

Practice address

16123 Grant Utley Ave NW
Cass Lake, MN 56633

Phone

(218) 335-3050

Fax

(218) 335-4410

NPI assigned

Oct 10, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Leech Lake Band of Ojibwe

  • Federally Qualified Health Center (FQHC)
  • Cass Lake, MN
  • NPI 1275823742
  NPD (past)

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1346644986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 6TH ST NW STE E",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333428",
            "telephone_number": "218-335-3050",
            "fax_number": "218-335-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16123 GRANT UTLEY AVE NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56633",
            "telephone_number": "218-335-3050",
            "fax_number": "218-335-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KATHLEEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roleen Ruth Walgenbach, RNP
• Sharon Kay Walker, FNP-CNP
• Rachel Washburn, PHARMD
• Danielle Whalen, LPN
• Anna Marie Woods, D.D.S.
• Randall E Wright, RPH
• Dawn Lucile Wyllie, MD
• Heather Rae Zimmel, AUDIOLOGIST

• Clinical Social Worker in Cass Lake, MN
• Providers in Cass Lake, 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 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.