Kyle Gregory Cloutier, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13976 Issued in MN

Practice address

1120 Centre Pointe Dr Ste 100
#100
Mendota Heights, MN 55120-1275

Phone

(952) 334-8278

Fax

(952) 891-4258

NPI assigned

Jan 19, 2007

Last updated

Jul 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Power of Progress Services, LLC

  dba Pops, LLC

  • Community/Behavioral Health Agency
  • Apple Valley, MN
  • NPI 1427516574
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1871646216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240125",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551240125",
            "telephone_number": "952-334-8278",
            "fax_number": "952-891-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 CENTRE POINTE DR STE 100",
            "address_2": "#100",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201275",
            "telephone_number": "952-334-8278",
            "fax_number": "952-891-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "KYLE",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "556368",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "505K6CL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "114510",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Annette Claflin
• John Jacob Clark, PHARM.D.
• Alexa Ann Clausen
• Hannah Jo Clemons
• Adam Closmore, PHARMD
• Bradley Cooper, DC
• Coram Alternate Site Services Inc (Coram CVS/specialty Infusion Services)
• Coram Alternate Site Services, Inc. (Coram CVS/specialty Infusion Services)
• Rylie Isabel Cormell
• Cottage Grove WP II, LLC

• Clinical Social Worker in Mendota Heights, MN
• Providers in Mendota Heights, 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 Jul 24, 2020; 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.