KATHRYN DAVIS TIDD
NPI 1285047738
Social Worker - Clinical in Moorhead, MN

Q: What is Kathryn Tidd's NPI number?

The NPI number for Kathryn Tidd is 1285047738. It was assigned to this individual provider in the NPPES registry on June 3, 2014. The provider is also known as Kathryn Davis Licsw.

Q: What is Kathryn Tidd's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kathryn Tidd was last updated on January 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 03, 2014PECOS Enrolled

815 37TH AVE S, MOORHEAD, MN 56560(701) 451-4811(651) 925-0057 Get Directions Write a Review

NPPES record last updated: January 21, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 21, 2021, May 29, 2019, Feb 22, 2017 (3 updates tracked since 2017).

On this page

About Kathryn Davis Tidd NPPES

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

KATHRYN DAVIS TIDD (NPI 1285047738) is an individual clinical provider in Moorhead, Minnesota, licensed in Minnesota (28095) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285047738

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameKATHRYN DAVIS TIDD

Location Address815 37TH AVE SMoorhead, MN 56560-5524

Mailing AddressPo Box 9859Fargo, ND 58106-9859 · (701) 451-4900 · Fax (651) 925-0057

Phone(701) 451-4811

Fax(651) 925-0057

Sole ProprietorNo

Enumeration DateJune 3, 2014

Last NPPES UpdateJanuary 21, 20213 updates tracked since enumeration

NPPES CertifiedJanuary 21, 2021

✔ NPI 1285047738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Licenses✔ Licensed in MN · 28095✔ Licensed in ND · 5057

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.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

815 37TH AVE S, Moorhead, MN 56560

Open in Google Maps ↗

Other Names 1

Professional Name (2)Kathryn Davis Licsw

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, HealthPartners, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathryn Davis Tidd 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 Reassignments

Medicare enrollment records show Kathryn Tidd reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Village Family Service Center

3.3 mi

Mental Health (Including Community Mental Health Center)

2701 12TH AVE S
Fargo, ND 58103

Reassigned Medicare billing, Minnesota and North Dakota enrollments
33 clinicians in this Medicare group

NPI 1568492353 (701) 451-4900

Southeast Behavioral Health Clinic

3.4 mi

Rehabilitation, Substance Use Disorder

2624 9TH AVE S
Fargo, ND 58103

Reassigned Medicare billing, North Dakota enrollment
Medicare enrollment name: Southeast Human Service Center
91 clinicians in this Medicare group

NPI 1932146941 (701) 298-4500

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 56560 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.

JONI LEA MEDENWALD MSW, LSW

Social Worker (Clinical)