KELLY M NELSON LICSW
NPI 1417223371
Social Worker - Clinical in Minnetonka, MN

Active since March 26, 2012PECOS EnrolledAccepts Medicare Assignment
11708 WAYZATA BLVD, MINNETONKA, MN 55305(952) 544-0964(952) 544-6405 Get Directions Write a Review

NPPES record last updated: March 26, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly M Nelson Licsw NPPES

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

KELLY M NELSON LICSW (NPI 1417223371) is an individual clinical provider in Minnetonka, Minnesota, licensed in Minnesota (19801) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1417223371
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY M NELSONCredential: LICSW
Location Address11708 WAYZATA BLVDMinnetonka, MN 55305-2014
Mailing Address4519 Quail Ave NRobbinsdale, MN 55422-1134 · (763) 222-6383 · Fax (952) 544-6405
Fax(952) 544-6405
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMarch 26, 2012
NPI 1417223371 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 · 19801
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.

11708 WAYZATA BLVD, Minnetonka, MN 55305

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kelly M Nelson Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103124920
PECOS Enrollment IDI20240713000168, I20251118002611
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55305 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 2

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

Social Worker (Clinical)
11708 WAYZATA BLVD
MINNETONKA, MN 55305
Social Worker (Clinical)
11708 WAYZATA BLVD
MINNETONKA, MN 55305

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 Kelly Nelson's NPI number?

The NPI number for Kelly Nelson is 1417223371. It was assigned to this individual provider in the NPPES registry on March 26, 2012.

Where is Kelly Nelson located?

Kelly Nelson practices at 11708 Wayzata Blvd, Minnetonka, MN 55305. The listed phone number is (952) 544-0964.

What is Kelly Nelson's specialty?

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

Is Kelly Nelson enrolled in Medicare?

Yes. Kelly Nelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kelly Nelson was last updated on March 26, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.