Alexis Kaelin Taylor, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29955 Issued in MN

Practice address

12400 Portland Ave Ste 180
Burnsville, MN 55337-6875

Phone

(952) 222-7704

NPI assigned

Aug 30, 2022

Reactivated

Dec 15, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Alexis Kaelin Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Elevation Therapy LLC

  • Clinical Social Worker
  • Burnsville, MN
  • NPI 1295623080
  NPD Authorized official

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1760102891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S SECOND AVE SUITE 200 #1151",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 PORTLAND AVE STE 180",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376875",
            "telephone_number": "952-222-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ALEXIS",
        "middle_name": "KAELIN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "deactivation_date": "2023-01-06",
        "reactivation_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "JOHNSON",
            "middle_name": "KAELIN",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jens Prem Tamang, OTR
• Marinel Tansia
• Olga Lidia Tapia-Farrell, LMFT
• Corinne J Tate, PT
• Jenna Leigh Tate, DO
• Camesheia Taylor
• Christine Marie Taylor, PT
• Linsey Taylor
• Tayo Skilled Services, Inc.
• Allison J Teachout, OTRL

• Clinical Social Worker in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.

Verify at the official NPI Registry.