Individual provider Active NPI

Kathryn A Lichty, LICSW

  • Clinical Social Worker
  • Alexandria, MN
National Provider Identifier
1477830263
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10139 Issued in MN
Practice address
1500 Irving St
Alexandria, MN 56308-2515
Phone
(320) 762-2400
Fax
(320) 762-8047
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10139 MN Primary

Addresses

Primary practice location

1500 Irving St
Alexandria, MN 56308-2515

Mailing address

1500 Irving St
Alexandria, MN 56308-2515
Phone (320) 762-2400

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
I20120208000217 MN Practitioner - Clinical Social Worker 1153588827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

625 Broadway St
Suite 102
Alexandria, MN 56308-1664
Phone (320) 808-3070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
One Hope Counseling, PLLC CurrentSince Nov 1, 2022 Accepting new patients
Nystrom & Associates, LTD Clinical PastSince Jul 18, 2022 Accepting new patients

Locations

625 Broadway St
Ste 102
Alexandria, MN 56308
Phone (320) 808-3070

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1477830263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 IRVING ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082515",
            "telephone_number": "320-762-2400",
            "fax_number": "320-762-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 IRVING ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082515",
            "telephone_number": "320-762-2400",
            "fax_number": "320-762-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTY",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.