Kayleen Rae Vieburg, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28654 Issued in MN

Practice address

11 Civic Center PLZ Ste 205
Mankato, MN 56001-7718

Phone

(073) 454-6795

Fax

(507) 345-8685

NPI assigned

Dec 13, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Addictions and Stress Clinics LTD

  • Psychologist
  • Mankato, MN
  • NPI 1376820118
  NPD

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1417668153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CIVIC CENTER PLZ STE 205",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017718",
            "telephone_number": "507-345-4679",
            "fax_number": "507-345-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CIVIC CENTER PLZ STE 205",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017718",
            "telephone_number": "073-454-6795",
            "fax_number": "507-345-8685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2277 Highway 36 W Ste 150",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551133830",
            "country_code": "US",
            "telephone_number": "507-345-1194",
            "fax_number": "507-345-8685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIEBURG",
        "first_name": "KAYLEEN",
        "middle_name": "RAE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@lifedrs.com",
            "affiliation": "N",
            "address_1": "7580 160th St W",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550448348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mattea Baubie Vetsch, PA-C
• Katerina Vetter
• Lindsey Vetter
• Angela Lee Vidden, LICSW
• Sandra L Vidotto, LICSW
• Andrew Villasenor, DO
• Jessica Kelly Villery, OTD, OTR/L
• Britni Vincent, RD, LD
• Vine Faith in Action
• Vision World Inc

• Clinical Social Worker in Mankato, MN
• Providers in Mankato, 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 Dec 5, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.