Katie Michelle Nystrom, LICSW, MSW

Individual provider Social Worker · NPI 1699355339

Katie Michelle Nystrom, LICSW, MSW is a Clinical Social Worker in Crosby, Minnesota. Qualified in 2016, 10 years ago. Practices with Ametrine Mental Health PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying: 10
Licensed in: MN
In the registry since: 2021

What do these letters mean?

LICSW — Licensed Independent Clinical Social Worker: The title some states use for an independently practising clinical social worker.
MSW — Master of Social Work: The graduate degree in social work.

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Practice location Address checks out

320 E Main St
Crosby, MN 56441
Phone: (218) 546-7000
Fax: (218) 546-4400

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

Specialties & licences

Social Worker (primary)	Taxonomy 104100000X · Licence 21668 (MN)

Record details

NPI number	1699355339
Entity type	Individual (Type 1)
Gender	Female
Credentials	LICSW , MSW
Sole proprietor	No
NPI enumerated	April 8, 2021
Last updated in NPPES	November 29, 2021
Certification date	November 29, 2021

Medicare enrollment

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

Medicare specialty	CLINICAL SOCIAL WORKER
Medical school	OTHER
Graduated	2016 (10 years in practice)
Group practice	Ametrine Mental Health Pllc — 5 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount