KELLY KNAEBLE (MSW, LICSW) – Clinical Social Worker, NPI 1164658431

KELLY KNAEBLE (MSW, LICSW) is a healthcare provider. based in New hope, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 16642 (MN). The NPI Number for KELLY KNAEBLE (MSW, LICSW) is 1164658431

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
KELLY KNAEBLE (MSW, LICSW)
NPI
1164658431
Phone
(763) 506-5266
Address
5555 BOONE AVE N
Enumeration Date
1 June 2009
Last Update Date
23 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5073343921
Graduation Year
2003 (23 years ago)
PAC ID
1658896865
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20250701000367
Address ID
MN550216337FA100XXAVEX300
Telehealth
Yes

Contacts

Secure Messaging
kknaeble718301@excellian.direct.allina.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness95
Years active:17State licenses:1Other names

2,310 CLINICAL SOCIAL WORKER in MN

Loading map...

Provider Addresses for KELLY KNAEBLE (MSW, LICSW)

  • 5555, Boone Avenue North, New Hope, Hennepin County, Minnesota, 55428, United States

    NEW HOPE, MN 554283636

    Phone: (763) 506-5266

    Type: Location

  • 100 STATE AVE

    FARIBAULT, MN 550216337

    Phone: (507) 334-3921

    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: 2025-07-01

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
I20250701000367IClinical 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.

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

Insurance plans in this area (ZIP 55428)

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: 4587573613View full group profile

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 NPI should I save for KELLY KNAEBLE (MSW, LICSW)?
Save NPI 1164658431 if you need a stable reference for KELLY KNAEBLE (MSW, LICSW).
Is KELLY KNAEBLE (MSW, LICSW) active in the national directory?
KELLY KNAEBLE (MSW, LICSW)'s public NPI profile is in an active state.
What kind of provider is KELLY KNAEBLE (MSW, LICSW)?
The page reflects Clinical Social Worker for KELLY KNAEBLE (MSW, LICSW). Clinical services aligned with this taxonomy classification.
Does KELLY KNAEBLE (MSW, LICSW) practice in Minnesota?
You will see New Hope, Minnesota on file for KELLY KNAEBLE (MSW, LICSW) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

Similar Providers

SARA BENSON (LICSW)

Clinical Social Worker
7066, Stillwater Boulevard North, Oakdale, Washington County, Minnesota, 55128, United States
NPI: 1518986389
5905, Golden Valley Road, Golden Valley, Hennepin County, Minnesota, 55422, United States
NPI: 1538265210

KATIE SUZANNE PERZEL (LICSW)

Clinical Social Worker
9220 BASS LAKE RD STE 255
NPI: 1033205174
5501 ELM GROVE CT
NPI: 1669690780

SUSAN MARIE ROERS (LICSW)

Clinical Social Worker
5555 BOONE AVE N
NPI: 1902068125
3000 AMES CROSSING RD STE 600
NPI: 1982834933

SUSAN ELLA SHAW (LCSW, ASCW)

Clinical Social Worker
4601 PARK COMMONS DR APT 215
NPI: 1841524634

NICOLE RAE BARNES (LICSW)

Clinical Social Worker
6500 EXCELSIOR BLVD
NPI: 1356649354