Active NPI
Connie Ann Schultz, MS, LICSW
- Marriage & Family Therapist
- Avon, MN
National Provider Identifier
1720176860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 6485LICSW
- Practice address
- 12533 355TH St
Avon, MN 56310-8736 - Phone
- (320) 363-8877
- Fax
- (320) 363-8821
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6485LICSW | MN | |
| Clinical Social Worker | 1041C0700X | 6485LICSW | MN | |
| Marriage & Family Therapist | 106H00000X | 6485LICSW | MN | Primary |
Addresses
Primary practice location
12533 355TH St
Avon, MN 56310-8736
Mailing address
12533 355TH St
Avon, MN 56310-8736
Phone (320) 363-8877
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 434M1SC | Other | MN | BLUE CROSS BLUE SHIELD |
| 434M2SC | Other | MN | BLUE CROSS BLUE SHIELD |
| HP27100 | Other | MN | HEALTH PARTNERS |
| 6203572 | Other | MN | MEDICA/UBH |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6485LICSW | MN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tamarix Counseling Services PA | Social Worker | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1720176860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12533 355TH ST",
"city": "AVON",
"state": "MN",
"postal_code": "563108736",
"telephone_number": "320-363-8877",
"fax_number": "320-363-8821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12533 355TH ST",
"city": "AVON",
"state": "MN",
"postal_code": "563108736",
"telephone_number": "320-363-8877",
"fax_number": "320-363-8821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "CONNIE",
"middle_name": "ANN",
"credential": "MS, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "6485LICSW",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "6485LICSW",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "6485LICSW",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "434M1SC",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "434M2SC",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP27100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA/UBH",
"identifier": "6203572",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.