Lisa Renee Kiesel, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10301 Issued in MN

Practice address

1599 Selby Ave # 2
.Suite 106
Saint Paul, MN 55104-6218

Phone

(612) 251-7967

NPI assigned

Aug 15, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Aslan Institute

  • Psychologist
  • Eagan, MN
  • NPI 1376690529
  NPD (past)
• Crosstown Counseling, PLC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1356453211
  NPD (past)
• Diamond Lake Clinic, P.C.

  • Health Service Clinic/Center
  • Minneapolis, MN
  • NPI 1740669498
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1477566826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 SELBY AVE # 2",
            "address_2": ".SUITE 106",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046218",
            "telephone_number": "612-251-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 SELBY AVE # 2",
            "address_2": ".SUITE 106",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046218",
            "telephone_number": "612-251-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESEL",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "800002196",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "866412900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Jean Kidd, M.ED., LAT, ATC
• Mary Kidder
• Kids Zone Development Center Inc
• Kathleen Ann Kiefer
• Michele Catherine Kieke, PHD, MS, LGC
• Sarah J Kiesling, MD
• Marlene Kiester, CRNA
• Steven R Kiester, DPM
• Feven Tekeste Kiflai, RN, LSN, MED
• Bethlehem Kiflom

• All providers in Saint Paul, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.