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NICOLE KRISTINA LIDSTROM LICSW
NPI 1033947601
Social Worker - Clinical in Mankato, MN

Active since July 24, 2024PECOS Enrolled
1025 MARSH ST, MANKATO, MN 56001(507) 594-2468 Get Directions Write a Review

NPPES record last updated: August 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nicole Kristina Lidstrom Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE KRISTINA LIDSTROM LICSW (NPI 1033947601) is an individual clinical provider in Mankato, Minnesota, licensed in Minnesota (26622) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033947601
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNICOLE KRISTINA LIDSTROMCredential: LICSW
Location Address1025 MARSH STMankato, MN 56001-4752
Mailing Address1025 Marsh StMankato, MN 56001-4752 · (507) 625-4031
Phone(507) 594-2468
Sole ProprietorNo
Enumeration DateJuly 24, 2024
Last NPPES UpdateAugust 26, 2024
NPPES CertifiedAugust 26, 2024
✔ NPI 1033947601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 26622
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1025 MARSH ST, Mankato, MN 56001
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Kristina Lidstrom Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Lidstrom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mayo Clinic Health System-Southwest Minnesota Region
0.1 mi
Multi-Specialty
1025 MARSH ST
Mankato, MN 56001
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,572 clinicians in this Medicare group
NPI 1578545422 (507) 625-4031

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIN MARIE CLIFFORD CNP
Nurse Practitioner
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 625-4031
PAUL L JOHNSON M.D.
Anesthesiology
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 345-2623
ELIZABETH CUMBERLAND NP
Nurse Practitioner (Family)
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 625-4031
DR. IGNACIO JUSUE TORRES M.D.
Neurological Surgery
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 625-1811
OMAR G FERRER ARNP
Nurse Practitioner
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 625-4031
JENNA JACKSON PHARM.D., R.PH.
Pharmacist
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 594-2999
SHARON R BRANDT CRNA
Nurse Anesthetist, Certified Registered
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 625-4031
RIPUDAMANJIT SINGH MD
Internal Medicine (Interventional Cardiology)
1025 MARSH ST
MANKATO, MN 56001
Blue Earth County (507) 625-4031

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Lidstrom's NPI number?

The NPI number for Nicole Lidstrom is 1033947601. It was assigned to this individual provider in the NPPES registry on July 24, 2024.

Where is Nicole Lidstrom located?

Nicole Lidstrom practices at 1025 Marsh St, Mankato, MN 56001. The listed phone number is (507) 594-2468.

What is Nicole Lidstrom's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Nicole Lidstrom enrolled in Medicare?

Yes. Nicole Lidstrom is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Lidstrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Lidstrom reassigns Medicare benefits to Mayo Clinic Health System-Southwest Minnesota Region (Mankato, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Lidstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Lidstrom was last updated on August 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.