Kelly Pieper, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22469 Issued in MN

Practice address

1611 County Road B W Ste 215
Roseville, MN 55113-4053

Phone

(612) 412-4201

NPI assigned

Jan 5, 2016

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

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

Medicare enrollment (NPD)

Enrolled

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD (past)

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1518323625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 LINDEN LN",
            "city": "CIRCLE PINES",
            "state": "MN",
            "postal_code": "550145475",
            "telephone_number": "920-819-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 215",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "612-412-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "481 Linden Ln",
            "address_purpose": "LOCATION",
            "city": "Circle Pines",
            "state": "MN",
            "postal_code": "550145475",
            "country_code": "US",
            "telephone_number": "920-819-9770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIEPER",
        "first_name": "KELLY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Grace Phelps
• Phoenix Sleep Solutions, LLC
• Physicians Neck & Back Clinics
• Physicians Neck and Back Clinics PA
• Erika Tyyne Pieniniemi, MPS, LPCC, LADC
• Jennifer Lee Pinion, LMFT
• Ryan N Plasch, MS, LPCC
• Platinum Health Regenerative Solutions, PA
• Philip C Pole, PHARM.D, R.PH
• Joshua Destura Policarpio, PHARMD

• Clinical Social Worker in Roseville, MN
• Providers in Roseville, 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 Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.