Michael Jeffery Kieke, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19015 Issued in MN

Practice address

155 Shady Ridge Rd NW
Hutchinson, MN 55350-1460

Phone

(320) 234-3451

NPI assigned

Mar 6, 2019

Sex

Male

Sole proprietor

No

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.

• Andrew J Larson Counseling Services

  • Marriage & Family Therapist
  • Hutchinson, MN
  • NPI 1962761981

  Clinical, MN

  Medicare reassignment Care Compare group NPD

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andrew J Larson Counseling Services 3 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 12, 2024.

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1982162228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 SHADY RIDGE RD NW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501460",
            "telephone_number": "320-234-3451",
            "fax_number": "320-587-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 SHADY RIDGE RD NW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553501460",
            "telephone_number": "320-234-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEKE",
        "first_name": "MICHAEL",
        "middle_name": "JEFFERY",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Lynn Kelso
• Hilary L Kerrick, DO
• Andrew Kezar, DPT
• Amer H Khan, MD
• Hassan Khidr, MD
• Danielle King
• Sue Ann Klassen, PTA
• Kati Klitzke, PSYD, LP
• Jammie Kay Klobes, NP-C
• Lacy Kloeckl

• All providers in Hutchinson, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.