Individual provider Active NPI

Sydney Fournier-Dingmann

  • Clinical Social Worker
  • Rogers, MN
National Provider Identifier
1003698622
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29906 Issued in MN
Practice address
14000 Northdale Blvd Ste I
Rogers, MN 55374-4663
Phone
(763) 575-8086
Fax
(320) 774-0415
NPI assigned
Oct 18, 2023
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29906 MN Primary

Addresses

Primary practice location

14000 Northdale Blvd Ste I
Rogers, MN 55374-4663

Mailing address

14000 Northdale Blvd Ste I
Rogers, MN 55374-4663
Phone (763) 575-8086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240126002941 MN Practitioner - Clinical Social Worker 1951754852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29906MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vanda Counseling and Psychological Services CurrentSince Dec 13, 2023 Accepting new patients

Locations

14000 Northdale Blvd
Ste I
Rogers, MN 55374
Phone (763) 575-8086

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1003698622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 NORTHDALE BLVD STE I",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744663",
            "telephone_number": "763-575-8086",
            "fax_number": "320-774-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 NORTHDALE BLVD STE I",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744663",
            "telephone_number": "763-575-8086",
            "fax_number": "320-774-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURNIER-DINGMANN",
        "first_name": "SYDNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, MN

Sources for this page

Verify at the official NPI Registry.