Craig L. Weickert, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12584 Issued in MN

Practice address

1010 32ND Ave S
Moorhead, MN 56560-5001

Phone

(218) 233-7524

Fax

(218) 233-8627

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Craig L. Weickert Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lakeland Mental Health Center

  • Case Manager/Care Coordinator
  • Fergus Falls, MN
  • NPI 1972950962
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033156393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 18TH ST N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601826",
            "telephone_number": "218-287-4484",
            "fax_number": "218-233-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 32ND AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605001",
            "telephone_number": "218-233-7524",
            "fax_number": "218-233-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEICKERT",
        "first_name": "CRAIG",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "116414",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1033073",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MINNESOTA",
            "identifier": "29A23WE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA BLUE SHIELD",
            "identifier": "22802",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "62=67001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP37867",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRAIG",
            "last_name": "WEICKERT",
            "middle_name": "L.",
            "credential": "MSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anna Webber
• Katelyn Weber
• Alexandra Erin Wede
• Krislea Erin Wegner, PHD
• Rachel Wegner
• Hannah Weiland
• Danielle Weller
• Kellie Alexa Welte
• Alyssa Wennerberg
• David Calvin Wentz, DDS

• Clinical Social Worker in Moorhead, MN
• Providers in Moorhead, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.