Lauren Andrea Maccoux Kizaur, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25455 Issued in MN

Practice address

1385 Mendota Heights Rd Ste 200
Mendota Heights, MN 55120-1289

Phone

(651) 379-9800

NPI assigned

Mar 27, 2019

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

Other identifiers 1

Other names 1

• Lauren Andrea Maccoux Former name

Electronic endpoints 1

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wild Tree Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1528451408
  Medicare reassignment NPD
• Family Adolescents and Children Therapy Services Inc.

  • Community/Behavioral Health Agency
  • Eagan, MN
  • NPI 1518053834
  NPD (past)
• Sarah C. Chambers, P.a.

  dba Crocus Hill Health Center

  • Health Service Clinic/Center
  • Saint Paul, MN
  • NPI 1942358379
  NPD (past)

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1548721079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 MENDOTA HEIGHTS RD STE 200",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201289",
            "telephone_number": "651-379-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 MENDOTA HEIGHTS RD STE 200",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201289",
            "telephone_number": "651-379-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZAUR",
        "first_name": "LAUREN",
        "middle_name": "ANDREA MACCOUX",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SOCIAL WORK",
            "identifier": "25455",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauren.kizaur@facts-mn.org",
            "affiliation": "Y",
            "endpointDescription": "email",
            "address_1": "1385 Mendota Heights Rd Ste 200",
            "city": "Mendota Heights",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551201289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "MACCOUX",
            "middle_name": "ANDREA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abdullahi Mohhamud Khalif
• Adrianna Aryanna Khang
• Juhee Kim
• Kathryn Loretta Kirchner
• Gayle L. Kittleson, LMFT
• Alyna Joy Kleinwolterink
• Kaytlyn Marie Knight
• Kimberly Knourek
• Taylor Koehler
• Daniel William Koski, R.PH.

• Clinical Social Worker in Mendota Heights, MN
• Providers in Mendota Heights, 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 Nov 27, 2023; 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.