Jeannine Katherine Myrvik, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15374 Issued in MN

Practice address

333 Smith Ave N
Saint Paul, MN 55102-2344

Phone

(651) 241-5618

Fax

(651) 241-7168

NPI assigned

Sep 6, 2007

Last updated

Sep 6, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 2001

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Minnesota Center for Psychology, LLCGroup PAC ID 2264583954, 15 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Minnesota Center for Psychology, LLC

  • Psychologist
  • Saint Paul, MN
  • NPI 1023258662
  Medicare reassignment Care Compare group NPD
• Medical Care Services, PA

  • Family Medicine Physician
  • New Brighton, MN
  • NPI 1083778708
  Medicare reassignment NPD
• Health and Wellness Collaborative

  • Clinical Psychologist
  • New Brighton, MN
  • NPI 1548822943
  NPD
• Psych Recovery Inc

  • Psychiatry Physician
  • Saint Paul, MN
  • NPI 1316189541

  Clinical

  NPD (past)
• Psychiatric Recovery PA

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Paul, MN
  • NPI 1891713681
  NPD (past)

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1043404775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-5618",
            "fax_number": "651-241-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-5618",
            "fax_number": "651-241-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRVIK",
        "first_name": "JEANNINE",
        "middle_name": "KATHERINE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Ann Myhervold
• Maria Mylonaki
• James Murray Mylrea, M.D.
• Isabella Myrland
• Ann V Myron Smith, CNNP
• N&L Prime Home Care LLC
• N&M DDS (Fischbach Dentistry)
• Sara Rademacher Nace, M.D.
• Natalie Dawn Nachtsheim
• Elana Nack, M.D.

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 6, 2007; 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.