Individual provider Active NPI

Christopher Lawler, LICSW, LADC

  • Clinical Social Worker
  • Shakopee, MN
National Provider Identifier
1548788680
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29094 Issued in MN
Practice address
200 4TH Ave W
Shakopee, MN 55379-1220
Phone
(952) 496-8481
Fax
(952) 496-8565
NPI assigned
Sep 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303670 MN
Clinical Social Worker 1041C0700X 29094 MN Primary

Addresses

Primary practice location

200 4TH Ave W
Shakopee, MN 55379-1220

Mailing address

200 4TH Ave W
Shakopee, MN 55379-1220
Phone (612) 965-3792

Other practice location 1

7701 York Ave S Ste 350
Edina, MN 55435-5832
Phone (952) 926-2526 ext. 105

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
I20260309000973 MN Practitioner - Clinical Social Worker 5799268702

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

808 W 80
Bloomington, MN 55420-5702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303670MNMDAddiction (Substance Use Disorder) Counselor
29094MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Scott CurrentSince Jan 11, 2026 Accepting new patients
County of Scott Addiction (Substance Use Disorder) CurrentSince Jan 11, 2026 Accepting new patients
Club Recovery LLC PastSince Jul 24, 2022 Accepting new patients

Locations

200 4th Ave W
Shakopee, MN 55379
Phone (952) 496-8481

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": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1548788680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "612-965-3792",
            "fax_number": "952-496-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8481",
            "fax_number": "952-496-8565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7701 York Ave S Ste 350",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554355832",
            "country_code": "US",
            "telephone_number": "952-926-2526 x105",
            "fax_number": "952-926-6791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWLER",
        "first_name": "CHRISTOPHER",
        "credential": "LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-08",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303670",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.