Tiana Monique Fitzsimmons, LICSW
Individual provider Active NPI Clinical Social Worker · Saint Peter, MN
NPI 1073014262 · NPPES record last updated May 3, 2018
Key facts
- NPI
- 1073014262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 20944 (MN)
- Practice address
- 1306 Marshall St
Saint Peter, MN 56082-4500 - Phone
- (507) 931-8040
- Fax
- (507) 931-8060
- NPI assigned
- Feb 23, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200522001677 | MN | Practitioner - Clinical Social Worker | 9739500091 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20944 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Services of Southern Minnesota, Inc | Clinical | Current |
Accepting new patients |
Locations
226 N Broad St
Mankato, MN 56001
Phone (507) 931-8040
1306 Marshall St
Saint Peter, MN 56082
Phone (507) 931-8040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20944 | MN | Yes |
Addresses
Primary practice location
1306 Marshall St
Saint Peter, MN 56082-4500
Mailing address
1306 Marshall St
Saint Peter, MN 56082-4500
Phone (507) 931-8040
Other practice location 1
226 N Broad St
Mankato, MN 56001-3520
Phone (507) 931-8040
Other practice location 2
760 Elmwood Ave S
Le Sueur, MN 56058-2169
Phone (507) 931-8040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20944 | Other | MN | LICSW |
Other names
- Tiana Woitas
Other providers in Saint Peter, MN
- Stefania Faraca
- Victoria Filzen
- Joseph Robert Finn
- Kendra Lee Finn
- Katelyn Fischbach
- Kristina Flattum
- Gabrielle Flesher
- James A Folden
- Foot & Ankle Clinic of St. Peter, Inc.
- Lisa Lee Fox
All providers in Saint Peter, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.