Active NPI
Kelly Laine Watson, MSW, LICSW
- School Social Worker
- Minneapolis, MN
National Provider Identifier
1891642971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 19731
- Practice address
- 1800 34TH Ave NE
Minneapolis, MN 55418-1498 - Phone
- (612) 668-1600
- NPI assigned
- Mar 16, 2026
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 19731 | MN | Primary |
Addresses
Primary practice location
1800 34TH Ave NE
Minneapolis, MN 55418-1498
Mailing address
1250 W Broadway Ave
Minneapolis, MN 55411-2533
Phone (612) 668-1600
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 |
|---|---|---|---|
| 19731 | MN | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1891642971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 W BROADWAY AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554112533",
"telephone_number": "612-668-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 34TH AVE NE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554181498",
"telephone_number": "612-668-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "KELLY",
"middle_name": "LAINE",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-16",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MN",
"license": "19731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.