Individual provider Active NPI

Kamrie Lynne Reed Ericson, LICSW

  • Clinical Social Worker
  • Burnsville, MN
National Provider Identifier
1720894926
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29733 Issued in MN
Practice address
1751 Southcross Dr W
Burnsville, MN 55306-7012
Phone
(952) 892-7690
Fax
(952) 898-4930
NPI assigned
Dec 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 29733 MN Primary

Addresses

Primary practice location

1751 Southcross Dr W
Burnsville, MN 55306-7012

Mailing address

3821 29TH Ave S
Minneapolis, MN 55406-3103
Phone (314) 629-7110

Other names 1

  • Kamrie Lynee Reed Former name

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
I20241209002303 MN Practitioner - Clinical Social Worker 7113453580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Verby Psychological Services Inc CurrentSince Dec 4, 2024 Accepting new patients
Hope Theory Professional Corporation Clinical CurrentSince Jun 23, 2025 Accepting new patients

Locations

1751 Southcross Dr W
Burnsville, MN 55306
Phone (952) 892-7690

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": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1720894926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 29TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554063103",
            "telephone_number": "314-629-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 SOUTHCROSS DR W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553067012",
            "telephone_number": "952-892-7690",
            "fax_number": "952-898-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "KAMRIE",
        "middle_name": "LYNNE REED",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAMRIE",
            "last_name": "REED",
            "middle_name": "LYNEE",
            "credential": "LCSW, LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.