Michelle A Kosmak, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15878 Issued in MN

Practice address

8085 Wayzata Blvd Ste 101B
Golden Valley, MN 55426-1468

Phone

(612) 825-1559

Fax

(612) 545-0100

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Michelle a Kosmak Licsw LLC

  • Clinical Social Worker
  • Golden Valley, MN
  • NPI 1487283644
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1578655759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD STE 101B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261468",
            "telephone_number": "612-825-1559",
            "fax_number": "612-545-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD STE 101B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261468",
            "telephone_number": "612-825-1559",
            "fax_number": "612-545-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSMAK",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "836108800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mollie Jean Kohler, LICSW
• Jane Elizabeth Kommer, LMFT
• Emma Kopp, MA
• Koski Stark Ghodge LLC
• Dayse Koski, LICSW
• Nicole Kraemer, PT
• Elizabeth Jean Krebsbach
• Rebecca Ann Krenz, LMFT
• Larry Kreuger, DDS
• Murali Krishnamurthy, MBBS, MSBE, MBA

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, 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 Apr 7, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.