Kathryn M Frydenlund, LCSW – Clinical Social Worker

Key facts

NPI: 1659433688
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 2745-123 (WI)
Practice address: 122 W South St
Viroqua, WI 54665-1943
Phone: (608) 637-2511
Fax: (608) 637-7921
NPI assigned: Dec 15, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Talkspace Provider Network PA Mental Health Clinic/Center (Including Community Mental Health Center) · New York, NY · NPI 1639814049

Medicare reassignment Care Compare group NPD WI
Psychiatric Associates Counseling Center LLC Mental Health Clinic/Center (Including Community Mental Health Center) · Viroqua, WI · NPI 1821141540

Medicare reassignment Care Compare group WI

Medicare Care Compare profile

Specialty: Clinical Social Worker
Education: Other, 1992
Medicare assignment: May accept Medicare assignment
Telehealth: Offers telehealth services
Group practices: Psychiatric Associates Counseling Center LLC (2 clinicians)
Talkspace Provider Network PA (249 clinicians)

Practice addresses (Care Compare)

122 W S St
Viroqua, WI 54665-1943
Phone (608) 637-2511

4026 S Burrell St
Milwaukee, WI 53207-4404
Phone (561) 221-5696

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20221212002272	WI	Practitioner - Clinical Social Worker	4981073053	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
2745-123	WI	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Talkspace Provider Network PA		Current since Mar 23, 2024	Accepting new patients

Locations

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	2745-123	WI	Yes

Addresses

Primary practice location

122 W South St
Viroqua, WI 54665-1943

Mailing address

1707 Main St
La Crosse, WI 54601-4200
Phone (608) 785-0001

Other identifiers

Identifier	Type	State	Issuer
39670800	Medicaid	WI

Other providers in Viroqua, WI

All providers in Viroqua, WI · Clinical Social Worker in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.