Individual provider Active NPI

Kendra Spielman, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1477083228
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23443 Issued in MN
Practice address
211 N 1St St Ste 335
Minneapolis, MN 55401-2800
Phone
(971) 220-2127
Fax
(844) 605-1865
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 23443 MN
Clinical Social Worker 1041C0700X L9517 OR
Clinical Social Worker 1041C0700X 23443 MN Primary

Addresses

Primary practice location

211 N 1St St Ste 335
Minneapolis, MN 55401-2800

Mailing address

211 N 1St St Ste 335
Minneapolis, MN 55401-2800
Phone (971) 220-2127

Other practice location 1

333 Washington Ave N Ste 406
Minneapolis, MN 55401-1370
Phone (971) 220-2127

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180820003221 MN Practitioner - Clinical Social Worker 4284983586 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L9517ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unrooted Counseling LLC Clinical CurrentSince Oct 5, 2024 Accepting new patients
Bushman Psychological Services LLC CurrentSince Jul 1, 2018 Accepting new patients

Locations

14551 Judicial Rd
Ste 100
Burnsville, MN 55306
Phone (952) 898-5020

333 Washington Ave N
Ste 406
Minneapolis, MN 55401
Phone (971) 220-2127

211 N 1st St
Ste 335
Minneapolis, MN 55401
Phone (971) 220-2127

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1477083228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N 1ST ST STE 335",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012800",
            "telephone_number": "971-220-2127",
            "fax_number": "844-605-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N 1ST ST STE 335",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012800",
            "telephone_number": "971-220-2127",
            "fax_number": "844-605-1865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Washington Ave N Ste 406",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554011370",
            "country_code": "US",
            "telephone_number": "971-220-2127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIELMAN",
        "first_name": "KENDRA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "23443",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L9517",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.