Individual provider Active NPI

Elizabeth Joan Horvat, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1629366877
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18358 Issued in MN
Practice address
2230 Como Ave
Saint Paul, MN 55108-1720
Phone
(888) 364-5977
Fax
(844) 385-4630
NPI assigned
Jul 20, 2011
Last updated
Jun 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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 008386 CT
Clinical Social Worker 1041C0700X 18358 MN Primary

Addresses

Primary practice location

2230 Como Ave
Saint Paul, MN 55108-1720

Mailing address

4505 White Bear Pkwy Ste 1500
White Bear Lake, MN 55110-3697
Phone (651) 439-8150

Other practice location 1

501 Lombard St
New Haven, CT 06513-2910
Phone (203) 787-2207

Other practice location 2

4045 White Bear Parkway Ste 1500
White Bear Lake, MN 55110
Phone (651) 493-8150

Other names 1

  • Ms. Elizabeth Joan Kittleson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008386CTMDClinical Social Worker
18358MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Connection Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1629366877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 WHITE BEAR PKWY STE 1500",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103697",
            "telephone_number": "651-439-8150",
            "fax_number": "651-493-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "888-364-5977",
            "fax_number": "844-385-4630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Lombard St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065132910",
            "country_code": "US",
            "telephone_number": "203-787-2207",
            "fax_number": "203-773-3626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4045 White Bear Parkway Ste 1500",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "55110",
            "country_code": "US",
            "telephone_number": "651-493-8150",
            "fax_number": "651-493-9335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORVAT",
        "first_name": "ELIZABETH",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008386",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "KITTLESON",
            "middle_name": "JOAN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.