Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacquelyn Lee Kerkow-Dohmen, LICSW

Individual provider Clinical Social Worker · NPI 1174186738

Jacquelyn Lee Kerkow-Dohmen, LICSW is a Clinical Social Worker in Shakopee, Minnesota. Qualified in 2016, 10 years ago. Practices with Northstar Regional, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2019
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

500 Marschall Rd Ste 100
Shakopee, MN 55379-2689
Phone: (952) 448-6557
Fax: (952) 448-6047
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 22546 (MN)

Record details

NPI number1174186738
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 19, 2019
Last updated in NPPESMay 15, 2024
Certification dateMay 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Northstar Regional — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Shakopee