Individual provider Active NPI

Angela Sue Cowan, MSW

  • Clinical Social Worker
  • Mendota Heights, MN
National Provider Identifier
1023442902
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29201 Issued in MN
Practice address
746 Decorah LN
Mendota Heights, MN 55120
Phone
(612) 568-7302
NPI assigned
Aug 27, 2013
Last updated
May 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 63805 TX
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 29201 MN Primary

Addresses

Primary practice location

746 Decorah LN
Mendota Heights, MN 55120

Mailing address

PO Box 50743
Mendota, MN 55150
Phone (612) 568-7302

Other practice location 1

5905 Golden Valley Rd
Golden Valley, MN 55422-4463
Phone (952) 546-0616

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
I20230720000409 MN Practitioner - Clinical Social Worker 8123338019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Jewish Family and Children's Service of MinneapolisGroup PAC ID 3870532500, 7 clinicians

Practice addresses (Care Compare)

5905 Golden Valley Rd
Golden Valley, MN 55422-4463
Phone (952) 546-0616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63805TXMDClinical Social Worker
29201MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family & Children's Service of Minneapolis CurrentSince May 7, 2023 Accepting new patients

Locations

5905 Golden Valley Rd
Minneapolis, MN 55422
Phone (952) 546-0616

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": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1023442902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50743",
            "city": "MENDOTA",
            "state": "MN",
            "postal_code": "55150",
            "telephone_number": "612-568-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 DECORAH LN",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "55120",
            "telephone_number": "612-568-7302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5905 Golden Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554224463",
            "country_code": "US",
            "telephone_number": "952-546-0616",
            "fax_number": "952-593-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COWAN",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63805",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota Heights, MN

Sources for this page

Verify at the official NPI Registry.