Kira Larson Fieldstrom, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25897 Issued in MN

Practice address

2400 Blaisdell Ave.
Minneapolis, MN 55404

Phone

(612) 516-5472

NPI assigned

Sep 13, 2017

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 names 1

• Kira Fielding Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1629597323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 17TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-735-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BLAISDELL AVE.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-516-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDSTROM",
        "first_name": "KIRA",
        "middle_name": "LARSON",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRA",
            "last_name": "FIELDING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Field, MA, LPCC
• Africa Fields
• Courtney Fields
• Emily Laing Fields, PSY.D.
• Robert Lee Fields, D.O.
• Gloria Ann Fier
• Nicolas Donovan Fierke
• Troy Alan Fiesel
• Kristen Kay Fiest, M.D.
• Alexandra Fife, PHARMD

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Sep 13, 2017; 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.