Active NPI
Kristin Elizabeth Gloe-Thordin, MSW, LICSW
- Clinical Social Worker
- Saint Paul, MN
National Provider Identifier
1790109155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 20981
- Practice address
- 771 Raymond Ave
Saint Paul, MN 55114-1522 - Phone
- (612) 235-6743
- Fax
- (612) 524-5527
- NPI assigned
- Feb 5, 2014
- Last updated
- Jan 4, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20981 | MN | Primary |
Addresses
Primary practice location
771 Raymond Ave
Saint Paul, MN 55114-1522
Mailing address
771 Raymond Ave
Saint Paul, MN 55114-1522
Phone (612) 235-6743
Other practice location 1
3333 University Ave SE
Minneapolis, MN 55414-3325
Phone (612) 728-5399 ext. 5552
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20981 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kristin Gloe-Thordin Therapy | Clinical | Current | Accepting new patients |
| Oliver Ross Psychology and Consulting LLC | Current | Accepting new patients | |
| Reclaim | Clinical | Current | Accepting new patients |
| Fraser | Past | Accepting new patients | |
| Fraser Child and Family Center | Past | Accepting new patients |
Locations
771 Raymond Ave
Saint Paul, MN 55114
Phone (612) 235-6743
Organizations & group practices 5
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.
-
- Clinical Social Worker
- Minneapolis, MN
- NPI 1013606425
-
- Group Psychotherapy Psychologist
- Saint Paul, MN
- NPI 1689030231
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Saint Paul, MN
- NPI 1811129430
Clinical
-
- Rehabilitation Clinic/Center
- Richfield, MN
- NPI 1063568574
-
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1609922194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1790109155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 RAYMOND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141522",
"telephone_number": "612-235-6743",
"fax_number": "612-524-5527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 RAYMOND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141522",
"telephone_number": "612-235-6743",
"fax_number": "612-524-5527"
}
],
"practiceLocations": [
{
"address_1": "3333 University Ave SE",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554143325",
"country_code": "US",
"telephone_number": "612-728-5399 x5552",
"fax_number": "612-728-5301",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GLOE-THORDIN",
"first_name": "KRISTIN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-05",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "20981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.