Individual provider Active NPI

Charles Westholm, LICSW

  • Clinical Social Worker
  • Minnetonka, MN
National Provider Identifier
1770454050
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31231 Issued in MN
Practice address
5125 County Road 101 Ste 300
Minnetonka, MN 55345-4157
Phone
(952) 932-7277
Fax
(952) 932-9827
NPI assigned
Sep 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 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 31231 MN Primary

Addresses

Primary practice location

5125 County Road 101 Ste 300
Minnetonka, MN 55345-4157

Mailing address

5125 County Road 101 Ste 300
Minnetonka, MN 55345-4157
Phone (952) 932-7277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1363 County B W
Apt C2
Roseville, MN 55113

5125 County Rd
101 Suite 300
Minnetonka, MN 55345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Relate Inc CurrentSince Sep 21, 2025 Accepting new patients

Locations

5125 County Road 101
Ste 300
Minnetonka, MN 55345
Phone (763) 241-3400

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": "1758067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1770454050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 COUNTY ROAD 101 STE 300",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454157",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 COUNTY ROAD 101 STE 300",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454157",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTHOLM",
        "first_name": "CHARLES",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.