Katelyn Connolly

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26289 Issued in MN

Practice address

38868 12TH Ave # 2021
North Branch, MN 55056-6658

Phone

(507) 565-6633

NPI assigned

Sep 9, 2020

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)

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.

• Chasing Calm Waters Psychotherapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Branch, MN
  • NPI 1780318154
  NPD Authorized official

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1417562299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38868 12TH AVE # 2021",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566658",
            "telephone_number": "507-427-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38868 12TH AVE # 2021",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566658",
            "telephone_number": "507-565-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chasing Calm Waters Psychotherapy LLC
• Mason Hope Clark, DC
• Andrew M Clary, D.O.
• Steven Lewis Clawson, DDS
• Clear Creek Dental
• County of Chisago (Chisago County Public Health Dept)
• County of Chisago (Chisago County Health)
• County Valu Pharmacy
• Jeffrey Cox, MD
• Jessica Joann Denning, APRN

• Clinical Social Worker in North Branch, MN
• Providers in North Branch, 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 9, 2023; 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.