Alicia Ann Vandenberg, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15924 Issued in MN

Practice address

2345 Ariel St N
Maplewood, MN 55109-2248

Phone

(651) 254-4793

Fax

(651) 254-0877

NPI assigned

Sep 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Acres for Life Therapy and Wellness CenterGroup PAC ID 3173983038, 7 clinicians

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Acres for Life Therapy & Wellness Center

  • Counselor
  • Chisago City, MN
  • NPI 1053702910
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1578932943
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1411257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411257600000",
    "number": "1023410107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 ARIEL ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092248",
            "telephone_number": "651-254-4793",
            "fax_number": "651-254-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 ARIEL ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092248",
            "telephone_number": "651-254-4793",
            "fax_number": "651-254-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "ALICIA",
        "middle_name": "ANN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-21",
        "last_updated": "2014-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usha Nurse LLC
• Christopher Neville Ussher, M.D.
• Larissa Vados, L.AC.
• Drew Alexander Valle
• Valley Eye Clinic & Optical, PA
• Charles Vang, M.D.
• Chrissy Vang, MOT, OTR/L
• Mai Ker Vang
• Mina Ly Vang
• Pafoua Vang

• Clinical Social Worker in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.