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

Kyan Bodden

Individual provider Clinical Social Worker · NPI 1194034686

Kyan Bodden is a Clinical Social Worker in Bloomington, Minnesota. Qualified in 2009, 17 years ago. Practices with Lyn-Lake Psychotherapy and Wellness Ltd, a 72-clinician group, works from 2 locations and offers telehealth. Licensed in Minnesota.

Years since qualifying
17
Licensed in
MN
In the registry since
2010
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Practice location Address checks out

7920 Old Cedar Ave S
Bloomington, MN 55425-1207
Phone: (952) 428-1800
Fax: (952) 428-1723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2265 Como Ave, Saint Paul, MN 55108-1737 — (651) 645-5323

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 16457 (MN)

Record details

NPI number1194034686
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 30, 2010
Last updated in NPPESApril 4, 2024
Certification dateApril 4, 2024
Mailing addressPo Box 43, Minneapolis, MN 55440-0043

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Lyn-Lake Psychotherapy And Wellness Ltd — 72 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Bloomington