Kandee Kubat Timmerman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15043 Issued in MN

Practice address

1404 Idaho Ave E
Saint Paul, MN 55106-1218

Phone

(612) 251-1753

NPI assigned

Oct 12, 2006

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

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stacia Hanson Ma LP LLCGroup PAC ID 2769828706, 8 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.

• Stacia Hanson Ma LP LLC

  dba Lilium Center

  • Psychologist
  • Edina, MN
  • NPI 1871867549
  Medicare reassignment Care Compare group NPD
• Minnesota Center for Psychology, LLC

  • Psychologist
  • Saint Paul, MN
  • NPI 1023258662
  Medicare reassignment NPD
• Centerlife Counseling, LLC

  • Mental Health Counselor
  • Centerville, MN
  • NPI 1417283946

  Clinical

  NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1437248713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 IDAHO AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551061218",
            "telephone_number": "612-251-1753",
            "fax_number": "888-977-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 IDAHO AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551061218",
            "telephone_number": "612-251-1753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4444 Centerville Rd Ste 235",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551273712",
            "country_code": "US",
            "telephone_number": "651-289-9396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1197 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551052634",
            "country_code": "US",
            "telephone_number": "763-703-4215",
            "fax_number": "877-775-3306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMERMAN",
        "first_name": "KANDEE",
        "middle_name": "KUBAT",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Tima
• Christy L Timm-Hughes, NP
• Liudmila Petrovna Timm, LPCC
• Michael R Timm, PAC
• Sydney Sarah Timm
• Richard C Timming, MD
• Jordan Timmons, LPCC
• Delphine Nayah-Chuo Timti, NP
• Tara Jean Tindall, PHARMD
• Lisa Michelle Tindell, RN

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 Feb 2, 2024; 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.