STEPHANIE KITZHABER (LICSW) – Clinical Social Worker, NPI 1356903447

STEPHANIE KITZHABER (LICSW) is a healthcare provider. based in Saint paul, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 22054 (MN). The NPI Number for STEPHANIE KITZHABER (LICSW) is 1356903447

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE KITZHABER (LICSW)
NPI
1356903447
Phone
(651) 659-2900
Address
762 TRANSFER RD STE 21
Enumeration Date
28 June 2019
Last Update Date
28 June 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6513306205
Graduation Year
2012 (14 years ago)
PAC ID
0749626638
Group Practice PAC ID
4688002579
Professional Enrollment ID
I20240314000343
Address ID
MN551133185RO2589XNXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for STEPHANIE KITZHABER (LICSW)

  • 762 TRANSFER RD STE 21

    SAINT PAUL, MN 551141489

    Phone: (651) 659-2900

    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: 2024-03-14

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
I20240314000343IClinical 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 55114)

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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: 4688002579View full group profile
NameSpecialtyState
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorWI
Marriage And Family TherapistMN

Reviews

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Frequently asked questions

Can I use this page to confirm STEPHANIE KITZHABER (LICSW)'s NPI?
Yes. STEPHANIE KITZHABER (LICSW) is listed with NPI 1356903447 in the public NPI dataset.
Does CMS list STEPHANIE KITZHABER (LICSW) as active?
Yes — STEPHANIE KITZHABER (LICSW) is active in the NPI listing used on this page.
What is STEPHANIE KITZHABER (LICSW) best known for clinically?
Directory data describes STEPHANIE KITZHABER (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for STEPHANIE KITZHABER (LICSW)?
STEPHANIE KITZHABER (LICSW)'s geographic hint is Saint Paul, Minnesota in our summary view.
Why does STEPHANIE KITZHABER (LICSW) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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