Love & Light Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LOVE & LIGHT COUNSELING, LLC

Practice address

690 Humboldt Dr Ste I&K
Big Lake, MN 55309-4812

Phone

(612) 208-8085

NPI assigned

Oct 1, 2024

Organization subpart

No

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

Authorized official

Name

Katie Ann Louise Shaw, LICSWNPI 1518046374

Title

Owner

Phone

(612) 208-8085

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katie Ann Louise Shaw, LICSW

  • Clinical Social Worker
  • Andover, MN
  • NPI 1518046374
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1427876028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 147TH LN NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043124",
            "telephone_number": "612-208-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 HUMBOLDT DR STE I&K",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094812",
            "telephone_number": "612-208-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVE & LIGHT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "ANN LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-208-8085",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Liebl
• Molly Lieser, MA, LPCC
• Lifesplace Counseling, Consulting and Coaching
• Tom Lindblom
• Kristine Lindgren
• Ashley Love, MS
• Susan Patrice Malecek, R.D.H.
• Saari Anne McCornack, PSYD
• Angela Lee McGee, PA-C
• Darla May Meier

• Clinical Social Worker in Big Lake, MN
• Providers in Big 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 Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.