Kristin Ann Schmidt, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12041 Issued in MN

Practice address

17 Ash Street
New London, MN 56273-0321

Phone

(320) 354-4200

Fax

(320) 354-4477

NPI assigned

Aug 31, 2016

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

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Willow Creek Counseling LLCGroup PAC ID 6204115322, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Willow Creek Counseling LLC

  • Clinical Social Worker
  • New London, MN
  • NPI 1538612239
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1801342696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562730321",
            "telephone_number": "320-354-4200",
            "fax_number": "320-354-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ASH STREET",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562730321",
            "telephone_number": "320-354-4200",
            "fax_number": "320-354-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "12041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Country Counseling LLC
• David Steven Roberts, PT
• Angelina Mae Rudningen, MSW/LICSW
• Kelsie Jean Rustad, PA-C
• Rachel Sawatzky
• Roxanne Schmiesing
• Steven J Shelver, MD
• Tessa Maline Slinden, PA-C
• Thomas Allen Sult, MD
• Summit Health Solutions

• Mental Health Counselor in New London, MN
• Providers in New London, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.