Individual provider Active NPI

William J Affeldt, MSSW LICSW

  • Clinical Social Worker
  • Walker, MN
National Provider Identifier
1013950203
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4248 Issued in MN
Practice address
310 Railroad Ave
Walker, MN 56484
Phone
(218) 675-9170
Fax
(320) 639-0014
NPI assigned
Jun 14, 2006
Last updated
Jan 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4248 MN
Clinical Social Worker 1041C0700X 4248 MN Primary

Addresses

Primary practice location

310 Railroad Ave
Walker, MN 56484

Mailing address

310 Railroad Ave
Walker, MN 56484
Phone (218) 675-9170

Other identifiers 5

IdentifierTypeStateIssuer
970757300MedicaidMN
HP27808OtherHEALTH PARTNERS
6248959OtherMEDICA
922241007835OtherPREFERRED ONE
110573C851OtherUCARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address waffeldt89500@direct.northmemorial.com

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
I20101004000692 MN Practitioner - Clinical Social Worker 4587856968

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1700 Hwy 25 N
Buffalo, MN 55313-1930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4248MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Pines Mental Health Center, Inc. CurrentSince Jan 11, 2026 Accepting new patients
Northern Pines Mental Health Center, Inc. PastSince Jan 11, 2026 Accepting new patients

Locations

1906 5th Ave SE
Little Falls, MN 56345
Phone (320) 639-2025

Interoperability endpoints

  • Direct secure messaging: waffeldt89500@direct.northmemorial.com

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1013950203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 RAILROAD AVE",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "56484",
            "telephone_number": "218-675-9170",
            "fax_number": "320-639-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 RAILROAD AVE",
            "city": "WALKER",
            "state": "MN",
            "postal_code": "56484",
            "telephone_number": "218-675-9170",
            "fax_number": "320-639-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFFELDT",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MSSW  LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "4248",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "4248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970757300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP27808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6248959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "922241007835",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "110573C851",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "waffeldt89500@direct.northmemorial.com",
            "affiliation": "N",
            "address_1": "1001 Hart Blvd Ste 100",
            "city": "Monticello",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553628929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walker, MN

Sources for this page

Verify at the official NPI Registry.