Individual provider Active NPI

Kylie Ann Godfrey, LCSW

  • Clinical Social Worker
  • Eau Claire, WI
National Provider Identifier
1629438197
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
132331 Issued in WI
Practice address
1221 Whipple St
Eau Claire, WI 54703-5200
Phone
(715) 838-5222
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 132331 WI Primary

Addresses

Primary practice location

1221 Whipple St
Eau Claire, WI 54703-5200

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (715) 838-5222

Other practice location 1

1120 Oak Ridge Dr
Eau Claire, WI 54701-6133
Phone (715) 246-4840

Other names 1

  • Kylie Ann Walker Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgodfrey2388581@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250205001843 WI Practitioner - Clinical Social Worker 4880124940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1221 Whipple St
Eau Claire, WI 54703-5270
Phone (715) 838-3806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
132331WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 14, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 14, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations

1221 Whipple St
Eau Claire, WI 54703
Phone (715) 831-0100

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Interoperability endpoints

  • Direct secure messaging: kgodfrey2388581@ehrdirect.mayoclinicmsg.org

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": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1629438197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 WHIPPLE ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035200",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 Oak Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016133",
            "country_code": "US",
            "telephone_number": "715-246-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "KYLIE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "132331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgodfrey2388581@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1221 Whipple St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547035200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "WALKER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.