MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) – Clinical Social Worker, NPI 1154422012

MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) is a healthcare provider. based in Bemidji, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 15400 (MN). The NPI Number for MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) is 1154422012

Main info

Female
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW)
NPI
1154422012
Phone
(218) 751-3280
Address
722 15TH STREET N.W.
Enumeration Date
25 September 2006
Last Update Date
13 December 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2183335000
Graduation Year
1995 (31 years ago)
PAC ID
3779516661
Group Practice PAC ID
5597725168
Professional Enrollment ID
I20050912000983
Address ID
MN566016151BE1705XNWXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW)

  • 722 15TH STREET N.W.

    BEMIDJI, MN 566190640

    Phone: (218) 751-3280

    Fax: (218) 751-3298

    Type: Location

  • Sioux Falls Post Office, 320, South 2nd Avenue, Downtown, Sioux Falls, Sioux Falls Township, Minnehaha County, South Dakota, 57104, United States

    SIOUX FALLS, SD 571175074

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2005-09-12

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
I20050912000983IClinical Social WorkerMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour21330$0
90791Psychiatric diagnostic evaluation2525$0
90834Psychotherapy, 45 minutes2111$0
View full utilization report →

Insurance plans in this area (ZIP 56619)

Loading plans...

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: 5597725168View full group profile
NameSpecialtyState
-MN
A N E S T H E S I O L O G YMN
Nurse PractitionerSD
-MN
Diagnostic RadiologyMN
N E U R O L O G YMN
-ND
-MN
O P T O M E T R YSD
Nurse PractitionerND

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What unique ID ties claims to MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW)?
NPI 1154422012 is assigned to MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) under the national enumeration system.
Is MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW)'s NPI currently valid?
The extract we use shows MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) as active.
Does MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW). Clinical services aligned with this taxonomy classification.
Does MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) practice in Minnesota?
You will see Bemidji, Minnesota on file for MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW) alongside any extra practice locations.
How can I contact MRS. KIMBERLY JEAN SLETTA AVENSON (MSW, LICSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

Similar Providers

GERI C WILIMEK (LICSW)

Clinical Social Worker
1526, 30th Street Northwest, Skyline Village Mobile Home Park, Bemidji, Beltrami County, Minnesota, 56601, United States
NPI: 1154328649
Beltrami Avenue Northwest, Bemidji, Beltrami County, Minnesota, 56601, United States
NPI: 1205813581

BOOSHKE MENTAL HEALTH INC.

Clinical Social Worker
2201 SHANNON LN SE
NPI: 1063464824

KATHRYN JANE FAVER (LICSW)

Clinical Social Worker
522 BELTRAMI AVE NW STE 17
NPI: 1639188543

TAMMY JAN JEDLICKA (MSW, LICSW)

Clinical Social Worker
16267 CARTER LAKE RD SE
NPI: 1982702361
111 LAKEWOOD DR NW
NPI: 1255431003
403, 4th Street Northwest, Bemidji, Beltrami County, Minnesota, 56601, United States
NPI: 1346340247

DONALD RAY TURK (LICSW)

Clinical Social Worker
718, Lincoln Avenue Southeast, Bemidji, Beltrami County, Minnesota, 56601, United States
NPI: 1326139114
900 Hilligoss Blvd SE
NPI: 1376639286