Abigail Lane, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21249 Issued in MN

Practice address

5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322

Phone

(763) 569-5200

Fax

(763) 569-5201

NPI assigned

Oct 6, 2014

Last updated

Mar 17, 2023By the provider in NPPES

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

Other names 1

• Abigail Simpson Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Northeast Youth & Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shoreview, MN
  • NPI 1639275852
  Medicare reassignment

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1083017040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DECATUR AVE N STE 109",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274363",
            "telephone_number": "763-227-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6425 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554231675",
            "country_code": "US",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Highway 7 Ste 309",
            "address_purpose": "LOCATION",
            "city": "Hopkins",
            "state": "MN",
            "postal_code": "553054737",
            "country_code": "US",
            "telephone_number": "952-426-6601",
            "fax_number": "952-938-4708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "ABIGAIL",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "SIMPSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Brooklyn Center, MN
• Providers in Brooklyn Center, 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 Mar 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.