Individual provider Active NPI

Katelyn Swanson

  • Clinical Social Worker
  • Fergus Falls, MN
National Provider Identifier
1962917419
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1205 N Tower Rd
Fergus Falls, MN 56537-1077
Phone
(218) 298-0083
NPI assigned
Dec 6, 2017
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 NU Primary

Addresses

Primary practice location

1205 N Tower Rd
Fergus Falls, MN 56537-1077

Mailing address

1205 N Tower Rd
Fergus Falls, MN 56537-1077

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
I20230811002979 MN Practitioner - Clinical Social Worker 9537521240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

235 W Main St
Suite F
Perham, MN 56573-1448
Phone (218) 325-2806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Productive Alternatives, Inc. CurrentSince Jul 8, 2024 Accepting new patients
Nuway Mental Health Clinic Past Accepting new patients
Productive Alternatives, Inc. Past Accepting new patients
Peaceful Mind Mental Health, LLC PastSince Mar 1, 2023 Accepting new patients

Locations

1205 N Tower Rd
Fergus Falls, MN 56537
Phone (218) 325-1084

235 W Main St
Ste F
Perham, MN 56573
Phone (218) 325-2806

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1962917419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N TOWER RD",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N TOWER RD",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371077",
            "telephone_number": "218-298-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.