Kathi Marie Ackerman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22793 Issued in MN

Practice address

280 Smith Ave N Ste 450
Saint Paul, MN 55102-2481

Phone

(651) 241-5959

NPI assigned

May 20, 2020

Last updated

May 20, 2020By the provider in NPPES

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 names 1

• Kathi Marie Ackerman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1437772803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 FOX TRL",
            "city": "ST BONIFACIUS",
            "state": "MN",
            "postal_code": "553751214",
            "telephone_number": "952-484-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 SMITH AVE N STE 450",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022481",
            "telephone_number": "651-241-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "KATHI",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHI",
            "last_name": "ACKERMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• 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 May 20, 2020; 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.