Elaina Marie Vig, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26967 Issued in MN

Practice address

3947 Excelsior Blvd Ste 110
Saint Louis Park, MN 55416-4779

Phone

(763) 222-5327

NPI assigned

Nov 12, 2021

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, 2021

Medicare assignment

May accept Medicare assignment

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.

• Fern Counseling PLLC

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1790356186
  Medicare reassignment NPD

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1023774197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HAMPSHIRE AVE S APT 203",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554262161",
            "telephone_number": "952-913-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3947 EXCELSIOR BLVD STE 110",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554164779",
            "telephone_number": "763-222-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIG",
        "first_name": "ELAINA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veterinary Ophthalmology Specialty Practice Inc
• Frederick Marcus Vickery, LPPC, LADC
• Jeannette Anna-Marie Vickman, LMFT
• Paul S Vietzen
• Donna Vig, LGSW
• Jayanthi Vijayakumar
• James Preston Viken, PHD, LP
• Trey Vilhauer
• Villa at St Louis Park LLC
• Villa at St. Louis Park LLC (The Villa at St. Louis Park)

• Clinical Social Worker in St Louis Park, MN
• Providers in St Louis Park, 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 Apr 3, 2024; 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.