Katie Marie Stadheim, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21955 Issued in MN

Practice address

1306 Marshall St
Saint Peter, MN 56082-4500

Phone

(507) 931-8040

Fax

(507) 931-8060

NPI assigned

Mar 5, 2015

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 identifiers 1

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Collaborative of MankatoGroup PAC ID 4688018138, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mental Health Collaborative of Mankato

  • Clinical Social Worker
  • Mankato, MN
  • NPI 1467234377
  Medicare reassignment Care Compare group NPD
• Counseling Services of Southern Minnesota, Inc

  • Clinical Social Worker
  • Saint Peter, MN
  • NPI 1962557496
  Medicare reassignment NPD
• Mankato Mental Health Associates, PA

  • Community/Behavioral Health Agency
  • Mankato, MN
  • NPI 1083863245
  Medicare reassignment NPD

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1376936047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 MARSHALL ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560824500",
            "telephone_number": "507-931-8040",
            "fax_number": "507-931-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 MARSHALL ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560824500",
            "telephone_number": "507-931-8040",
            "fax_number": "507-931-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADHEIM",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "21955",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St Peter Family Dental Center, P.a.
• St. Peter Eyecare Center
• St. Peter Public Schools
• St. Peter Regional Treatment Center
• St. Peter Regional Treatment Center
• Katie M Stadther, PSYD, LP
• Noah Stageberg
• State Operated Forensic Nursing Services
• Courtney Sticha
• Gavin Stodden

• Clinical Social Worker in Saint Peter, MN
• Providers in Saint Peter, 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 Sep 9, 2021; 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.