Individual provider Active NPI

Kaylen Victoria Stiever, LICSW, MSW

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1902417512
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29223 Issued in MN
Practice address
1522 E Superior St
Duluth, MN 55812-1634
Phone
(218) 391-3215
NPI assigned
Aug 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 29223 MN Primary

Addresses

Primary practice location

1522 E Superior St
Duluth, MN 55812-1634

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other practice location 1

615 Pecan Ave
Duluth, MN 55811-2749
Phone (218) 355-2136

Other names 1

  • Kaylen Victoria Knutson Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240610000795 MN Practitioner - Clinical Social Worker 4981146636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29223MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Accend Services Incorporated CurrentSince Oct 25, 2021 Accepting new patients
SMDC Medical Center CurrentSince Jun 10, 2024 Accepting new patients
SMDC Medical Center PastSince Jun 10, 2024 Accepting new patients

Locations

1522 E Superior St
Duluth, MN 55812
Phone (218) 391-3215

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

615 Pecan Ave
Duluth, MN 55811
Phone (218) 355-2100

Organizations & group practices 3

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": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1902417512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121634",
            "telephone_number": "218-391-3215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Pecan Ave",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558112749",
            "country_code": "US",
            "telephone_number": "218-355-2136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIEVER",
        "first_name": "KAYLEN",
        "middle_name": "VICTORIA",
        "credential": "LICSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEN",
            "last_name": "KNUTSON",
            "middle_name": "VICTORIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.