Individual provider Active NPI

Courtney Schallock, LICSW

  • Clinical Social Worker
  • Owatonna, MN
National Provider Identifier
1356225171
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2575 Harvest LN
Owatonna, MN 55060-4305
Phone
(507) 446-0431
Fax
(507) 446-8014
NPI assigned
Aug 4, 2025
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 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 Primary

Addresses

Primary practice location

2575 Harvest LN
Owatonna, MN 55060-4305

Mailing address

2575 Harvest LN
Owatonna, MN 55060-4305
Phone (507) 446-0431

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
I20250815000186 MN Practitioner - Clinical Social Worker 7810496189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2575 Harvest LN
Owatonna, MN 55060-4305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fernbrook Family Center, Inc CurrentSince Aug 4, 2025 Accepting new patients
Fernbrook Family Center Past Accepting new patients

Locations

2575 Harvest Ln
Owatonna, MN 55060
Phone 5074460431115

Organizations & group practices 2

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": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1356225171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 HARVEST LN",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604305",
            "telephone_number": "507-446-0431",
            "fax_number": "507-446-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 HARVEST LN",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604305",
            "telephone_number": "507-446-0431",
            "fax_number": "507-446-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLOCK",
        "first_name": "COURTNEY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.