Lynn Renee Carlson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21662 Issued in MN

Practice address

1811 Weir Dr
Suite 270
Woodbury, MN 55125-2272

Phone

(651) 714-9646

Fax

(651) 714-9647

NPI assigned

Jul 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lynn Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1881046282",
    "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": "651-714-9646",
            "fax_number": "651-714-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 WEIR DR",
            "address_2": "SUITE 270",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252272",
            "telephone_number": "651-714-9646",
            "fax_number": "651-714-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "LYNN",
        "middle_name": "RENEE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ariel Lynn Carls, MD
• Sarah Lynn Carlson-Bradley, CNP
• Janet Lorraine Carlson-Casa de Calvo, PT
• Jonae Carlson
• Kelsey Joy Carlson, PA-C
• Dana Carlton, PHARM.D.
• Barry J Carnahan, DACCHM, L.AC.
• Safiyya Carrim
• Mary C Carroll, MSSW, LICSW
• Patricia Ann Carroll, OTRL

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, 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 Aug 29, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.