MS. LAURIE LYNNE NELSON (LICSW) – Clinical Social Worker, NPI 1386785855

MS. LAURIE LYNNE NELSON (LICSW) is a healthcare provider. based in Minnetonka, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 22334 (MN). The NPI Number for MS. LAURIE LYNNE NELSON (LICSW) is 1386785855

Main info

Female
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
MS. LAURIE LYNNE NELSON (LICSW)
NPI
1386785855
Phone
(763) 464-7460
Address
10505 Wayzata Blvd
Enumeration Date
9 February 2007
Last Update Date
23 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9524434600
Graduation Year
2000 (26 years ago)
PAC ID
7517016983
Group Practice PAC ID
7810282845
Professional Enrollment ID
I20190403000540
Address ID
MN553182567CH1435XDRXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for MS. LAURIE LYNNE NELSON (LICSW)

  • 10505 Wayzata Blvd

    Suite 200

    Minnetonka, MN 553051502

    Phone: (763) 464-7460

    Type: Location

  • 10505 WAYZATA BLVD

    SUITE 200

    MINNETONKA, MN 553051502

    Phone: (763) 464-7460

    Type: Mailing

  • 3395 Plymouth Rd

    Minnetonka, MN 553053765

    Phone: (952) 939-0396

    Type: Location

  • 1200 MARQUETTE AVE

    MINNEAPOLIS, MN 554032419

    Phone: (952) 939-0396

    Type: Location

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: 2019-04-03

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
I20190403000540IClinical 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 55305)

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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: 7810282845View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Can I cross-check MS. LAURIE LYNNE NELSON (LICSW) using NPI 1386785855?
NPI 1386785855 belongs to MS. LAURIE LYNNE NELSON (LICSW); compare other details if you need extra assurance.
Would MS. LAURIE LYNNE NELSON (LICSW) appear as active to a payer?
You can treat MS. LAURIE LYNNE NELSON (LICSW) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for MS. LAURIE LYNNE NELSON (LICSW)?
At a glance, MS. LAURIE LYNNE NELSON (LICSW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MS. LAURIE LYNNE NELSON (LICSW)?
Travel planning: use Minnetonka, Minnesota as the reference point for MS. LAURIE LYNNE NELSON (LICSW), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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