Individual provider Active NPI

Angela Khalar, MSW, LICSW

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1831549260
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20457 Issued in MN
Practice address
332 W Superior St
Suite 300
Duluth, MN 55802-1808
Phone
(218) 722-4379
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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 20457 MN Primary

Addresses

Primary practice location

332 W Superior St
Suite 300
Duluth, MN 55802-1808

Mailing address

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 628-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160630001772 MN Practitioner - Clinical Social Worker 3779875356 Reassigns benefits to 2 organizations
I20230328000193 WI Practitioner - Clinical Social Worker 3779875356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical CurrentSince Jul 25, 2016 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Mar 1, 2023 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Mar 1, 2023 Accepting new patients

Locations

332 W Superior St
Ste 300
Duluth, MN 55802
Phone (218) 481-9408

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

2500 E Enterprise Ave
Ste B
Appleton, WI 54913
Phone (920) 416-8577

3703 Oakwood Hills Pkwy
Ste 100
Eau Claire, WI 54701
Phone (534) 444-4562

2501 Hanley Rd
Ste 201
Hudson, WI 54016
Phone (534) 544-5247

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

1001 Fourier Dr
Ste 200
Madison, WI 53717
Phone (608) 740-2001

Organizations & group practices 4

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1831549260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 W SUPERIOR ST",
            "address_2": "SUITE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021808",
            "telephone_number": "218-722-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALAR",
        "first_name": "ANGELA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.