COURTNEY K SEDGWICK (LICSW) – Clinical Social Worker, NPI 1255647954

COURTNEY K SEDGWICK (LICSW) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 16973 (MN). The NPI Number for COURTNEY K SEDGWICK (LICSW) is 1255647954

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
COURTNEY K SEDGWICK (LICSW)
NPI
1255647954
Phone
(612) 273-5062
Address
2450 RIVERSIDE AVE
Enumeration Date
19 August 2010
Last Update Date
15 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3207530778
Graduation Year
2004 (22 years ago)
PAC ID
3375777469
Group Practice PAC ID
6406752492
Professional Enrollment ID
I20210811002426
Address ID
MN553501819HU114XXNXXX401
Telehealth
Yes

Contacts

Other Endpoint
Www.nystromcounseling.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:15State licenses:1Other namesUpdated within 12 months

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for COURTNEY K SEDGWICK (LICSW)

  • 2450 RIVERSIDE AVE

    SUITE NG 14

    MINNEAPOLIS, MN 554541450

    Phone: (612) 273-5062

    Fax: (612) 273-6692

    Type: Mailing

  • 114 MAIN ST N STE 201B

    HUTCHINSON, MN 553501819

    Phone: (320) 753-0778

    Fax: (320) 753-0779

    Type: Mailing

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: 2023-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20210811002426IClinical Social WorkerMNTBD
I20230516002275IClinical Social WorkerNDTBD

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 55454)

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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: 6406752492View full group profile
NameSpecialtyState
-GA
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorMN
-MN

Reviews

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Frequently asked questions

Does COURTNEY K SEDGWICK (LICSW) have a public NPI I can cite?
Public records show COURTNEY K SEDGWICK (LICSW) under NPI 1255647954.
Is COURTNEY K SEDGWICK (LICSW) currently accepting referrals based on NPI status?
Registry metadata lists COURTNEY K SEDGWICK (LICSW) as active.
What services align with COURTNEY K SEDGWICK (LICSW)'s listing?
COURTNEY K SEDGWICK (LICSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What city is tied to COURTNEY K SEDGWICK (LICSW)?
The directory associates COURTNEY K SEDGWICK (LICSW) with Minneapolis, Minnesota. Check all listed addresses for suites or satellite offices.
Who maintains COURTNEY K SEDGWICK (LICSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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