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

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andrew J Larson Counseling ServicesGroup PAC ID 7113469594, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Andrew J Larson Counseling Services

  dba NorthStar Counseling Center

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

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "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

• Clinical Social Worker in Hutchinson, MN
• Providers in Hutchinson, 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 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.