Kathleen Connolly-Piumbroeck, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

04921 Issued in MN

Practice address

3100 W Lake St
Ste 320
Minneapolis, MN 55416-4527

Phone

(612) 928-1975

Fax

(612) 929-9006

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kathleen C Piumbroeck Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 5, 2019 through Mar 5, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992888010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 WESSEL CT",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553461126",
            "telephone_number": "952-949-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST",
            "address_2": "STE 320",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164527",
            "telephone_number": "612-928-1975",
            "fax_number": "612-929-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY-PIUMBROECK",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "04921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN TAX ID NUMBER",
            "identifier": "1472721",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "PIUMBROECK",
            "middle_name": "C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Connections Health Center
• Jennifer Connell, LAC
• Allison Taylor Connelly
• Anna Jarombek Connelly, PHARMD
• Kathleen Conner, PA-C
• Bonnie Lynn Connolly, RNC, ANP
• Rick Allen Connolly, RN
• Allyson C Connor, MD
• Jennifer Connor, PHD LMFT
• Kevin A Connor, DDS

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.