Jacquelyn Lee Kerkow-Dohmen, LICSW
NPI 1174186738ActiveIndividual· Social Worker, Clinical· Shakopee, MN
Social Worker, Clinical (LICSW) with Northstar Regional, practicing in Shakopee, Minnesota. Medicare paid $9,341 for services to 27 patients in 2024.
Overview
| NPI | 1174186738 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | No |
| NPI issued | Apr 19, 2019 |
| Last updated in NPPES | May 15, 2024 |
| Certified by provider | May 15, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 22546 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 27 |
|---|---|
| Services billed | 139 across 5 procedure codes |
| Paid by Medicare | $9,341 |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Northstar RegionalChaska, MN · 7 clinicians
Other Social Worker, Clinical providers in Shakopee
- 1760302335
- 1508263039
- 1356184303
- 1689928871
- 1295694529
- 1619848355
- 1740981042
- 1831341650
- 1205025822
- 1093713935
- 1780174938
- 1447588546