Individual provider Active NPI

Kristen Mary Schmidt-Shay, LICSW

  • Clinical Social Worker
  • Eden Prairie, MN
National Provider Identifier
1740362300
Registry record updated Jun 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14824 Issued in MN
Practice address
9531 W 78TH St Ste 220
Eden Prairie, MN 55344-3863
Phone
(952) 395-3290
Fax
(952) 214-7490
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2026

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 14824 MN Primary

Addresses

Primary practice location

9531 W 78TH St Ste 220
Eden Prairie, MN 55344-3863

Mailing address

9531 W 78TH St Ste 220
Eden Prairie, MN 55344-3863
Phone (952) 395-3290

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
I20031222000144 MN Practitioner - Clinical Social Worker 4789582339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians
Becoming Together Therapy and Wellness LLCGroup PAC ID 3678588399, 3 clinicians

Practice addresses (Care Compare)

3100 W Lake St
Suite 210
Minneapolis, MN 55416-4597
Phone (612) 925-6033

9531 W 78TH St
Suite 220
Eden Prairie, MN 55344-3810
Phone (953) 932-3290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Becoming Together Therapy and Wellness LLC Clinical CurrentSince May 3, 2026 Accepting new patients

Locations

9531 W 78th St
Ste 220
Eden Prairie, MN 55344
Phone (952) 395-3290

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780790400000",
    "number": "1740362300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9531 W 78TH ST STE 220",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443863",
            "telephone_number": "952-395-3290",
            "fax_number": "952-214-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9531 W 78TH ST STE 220",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443863",
            "telephone_number": "952-395-3290",
            "fax_number": "952-214-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT-SHAY",
        "first_name": "KRISTEN",
        "middle_name": "MARY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-06-07",
        "certification_date": "2026-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.