Individual provider Active NPI

Annette M Duerscherl, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1053645135
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18039 Issued in MN
Practice address
345 Smith Ave N
Saint Paul, MN 55102-2346
Phone
(612) 871-1454
Fax
(612) 871-1505
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18039 MN Primary

Addresses

Primary practice location

345 Smith Ave N
Saint Paul, MN 55102-2346

Mailing address

345 Smith Ave N
Saint Paul, MN 55102-2346

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
I20120419000795 MN Practitioner - Clinical Social Worker 6709047665 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

1155 Northland Dr
Mendota Heights, MN 55120-1288
Phone (612) 223-8898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18039MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Woodwinds Hospital CurrentSince Feb 1, 2012 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Feb 1, 2012 Accepting new patients
Healtheast Medical Research Institute Clinical CurrentSince Feb 1, 2012 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Clinical CurrentSince Apr 15, 2025 Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 1, 2012 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 15, 2025 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Care Clinics, LLC CurrentSince Apr 1, 2023 Accepting new patients
Optum Behavioral Care of Colorado PC Past Accepting new patients

Locations

7400 W 109th St
Bloomington, MN 55438
Phone (952) 886-3268

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1155 Northland Dr
Saint Paul, MN 55120
Phone (612) 223-8899

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

7601 Wayzata Blvd
St Louis Park, MN 55426
Phone (612) 223-8899

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1053645135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUERSCHERL",
        "first_name": "ANNETTE",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.