Poplar Grove Counseling, PLLP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22716 Issued in MN

Legal business name

POPLAR GROVE COUNSELING, PLLP

Practice address

3011 36TH Ave S
Suite 9
Minneapolis, MN 55406-2796

Phone

(612) 578-5181

NPI assigned

Oct 18, 2015

Organization subpart

No

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

Authorized official

Name

Alissa Dawn Kaasa, LICSWNPI 1700265246

Title

Therapist, Managing Partner

Phone

(612) 578-5181

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alissa Kaasa

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1700265246
  Medicare reassignment Care Compare group NPD Authorized official
• Sally Renee Vanerstrom, L.I.C.S.W.

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1114065810
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1445126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1083085989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 36TH AVE S",
            "address_2": "SUITE 9",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062796",
            "telephone_number": "651-335-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 36TH AVE S",
            "address_2": "SUITE 9",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062796",
            "telephone_number": "612-578-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPLAR GROVE COUNSELING, PLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "KAASA",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "THERAPIST, MANAGING PARTNER",
        "authorized_official_telephone_number": "612-578-5181",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16268",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20307",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17710",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Le Shondra Pope
• Morgan Pope
• Rachel Marie Popham
• Michael K Popkin, MD
• Jonathan Stanley Popko, CNP
• Constance Poplos, MD, MS
• Emily Dianne Popma, MD
• Fatai Adeshina Popoola, LICSW,LADC
• Jordan Popp, CRNA
• Sophia M Poppert, PA-C

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.