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

Individual provider Clinical Social Worker · NPI 1366852972

Kotatee Tamba, LP, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2020, 6 years ago. Practices with Catalyst Mental Health, Gbc, a 28-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2014
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2500 2nd St NE Apt 607
Minneapolis, MN 55418-3588
Phone: (651) 497-9483
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP7120 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 21317 (MN)

Record details

NPI number1366852972
Entity typeIndividual (Type 1)
GenderMale
Credentials LP , LICSW
Sole proprietorNo
NPI enumeratedMay 5, 2014
Last updated in NPPESNovember 4, 2024
Certification dateNovember 4, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Catalyst Mental Health, Gbc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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