Individual provider Active NPI

Kirsten Sharp, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1497387542
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32126 Issued in MN
Practice address
7601 Wayzata Blvd
Minneapolis, MN 55426-1623
Phone
(612) 223-8898
Fax
(612) 223-8899
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 32126 MN Primary
Social Worker 104100000X 6698-C AR

Addresses

Primary practice location

7601 Wayzata Blvd
Minneapolis, MN 55426-1623

Mailing address

7601 Wayzata Blvd
Minneapolis, MN 55426-1623
Phone (612) 223-8898

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
I20230504001235 MN Practitioner - Clinical Social Worker 1658736251 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6698-CARMDSocial Worker
32126MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Behavioral Health & Wellness LLC CurrentSince Dec 24, 2025 Accepting new patients
Professional Counseling Associates Inc. PastSince May 31, 2020 Accepting new patients
Professional Counseling Associates Inc. PastSince Jan 1, 2024 Accepting new patients

Locations

6375 W 143rd St
Savage, MN 55378
Phone (952) 592-2200

Organizations & group practices 3

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": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1497387542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261623",
            "telephone_number": "612-223-8898",
            "fax_number": "612-223-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261623",
            "telephone_number": "612-223-8898",
            "fax_number": "612-223-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "KIRSTEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "32126",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "6698-C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.