Individual provider Active NPI

Kelli Larson, LICSW

  • Clinical Social Worker
  • Winona, MN
National Provider Identifier
1689569865
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
420 E Sarnia St Ste 2100
Winona, MN 55987-6414
Phone
(507) 454-4341
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

420 E Sarnia St Ste 2100
Winona, MN 55987-6414

Mailing address

420 E Sarnia St Ste 2100
Winona, MN 55987-6414

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250814004189 MN Practitioner - Clinical Social Worker 9931608270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hiawatha Valley Mental Health Center IncGroup PAC ID 7113026998, 25 clinicians

Practice addresses (Care Compare)

221 S Kingston St
Caledonia, MN 55921-1317
Phone (507) 725-2022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hiawatha Valley Mental Health Center Inc. CurrentSince Jun 4, 2025 Accepting new patients
Hiawatha Valley Mental Health Center CurrentSince Jun 4, 2025 Accepting new patients

Locations

221 S Kingston St
Caledonia, MN 55921
Phone (507) 725-2022

611 Broadway Ave
Ste 100
Wabasha, MN 55981
Phone (651) 565-2234

420 E Sarnia St
Ste 2100
Winona, MN 55987
Phone (507) 454-4341

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.

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1689569865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E SARNIA ST STE 2100",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SARNIA ST STE 2100",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876414",
            "telephone_number": "507-454-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KELLI",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.