JODY KAY DUNLAP (LICSW) – Clinical Social Worker, NPI 1073593612

JODY KAY DUNLAP (LICSW) is a healthcare provider. based in Stillwater, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 8183 (MN). The NPI Number for JODY KAY DUNLAP (LICSW) is 1073593612

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
JODY KAY DUNLAP (LICSW)
NPI
1073593612
Phone
(651) 439-4840
Address
1875 NORTHWESTERN AVE S
Enumeration Date
19 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8088254212
Graduation Year
1985 (41 years ago)
PAC ID
1557394897
Group Practice PAC ID
6406263342
Professional Enrollment ID
I20220823003297
Address ID
HI967202860HI224XXAVEX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for JODY KAY DUNLAP (LICSW)

  • 1875, Northwestern Avenue, Stillwater, Washington County, Minnesota, 55082, United States

    STILLWATER, MN 550827534

    Phone: (651) 439-4840

    Fax: (651) 439-4894

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-08-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220823003297IClinical Social WorkerHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55082)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406263342View full group profile
NameSpecialtyState
Clinical Social WorkerCA
Mental Health CounselorHI
Clinical PsychologistHI
Clinical Social WorkerNC

Reviews

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Frequently asked questions

Is there an official ID for JODY KAY DUNLAP (LICSW) in U.S. healthcare records?
The official identifier for JODY KAY DUNLAP (LICSW) is NPI 1073593612.
Active or inactive — what applies to JODY KAY DUNLAP (LICSW)?
You should see JODY KAY DUNLAP (LICSW) as active in CMS-hosted NPPES data.
What expertise is attributed to JODY KAY DUNLAP (LICSW)?
JODY KAY DUNLAP (LICSW)'s specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is JODY KAY DUNLAP (LICSW) associated with Stillwater?
Public fields place JODY KAY DUNLAP (LICSW) around Stillwater, Minnesota. Always confirm the exact site before visiting.
Can I trust this NPI listing for JODY KAY DUNLAP (LICSW)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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