Jennifer Egeland, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22565 Issued in MN

Practice address

5555 Boone Ave N
New Hope, MN 55428-3636

Phone

(763) 504-7893

NPI assigned

Aug 29, 2017

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

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, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Mary Mullenbach PHD LP IncGroup PAC ID 5799950283, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Mary Mullenbach, PHD, LP, Inc

  • Psychologist
  • Edina, MN
  • NPI 1801182837
  Medicare reassignment Care Compare group NPD
• St. Croix Psychiatric, LLC

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1083131197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16725 12TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554473001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 BOONE AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283636",
            "telephone_number": "763-504-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGELAND",
        "first_name": "JENNIFER",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Debra L. Amundson DDS. P.a
• Brenda Lee Drimmel, R.N.
• Lindsey Drooger, COTA
• Beatrice May Dryja, M.A., CCC-SLP
• Dway Eastern Therapeutic Bodywork LLC
• Michael Robert Eggerichs, PHARM. D.
• Empower You Physical Therapy and Wellness
• Johanna Rae Erickson
• Escuela Exitos Charter School
• Essence Home Health Care, LLC

• Clinical Social Worker in New Hope, MN
• Providers in New Hope, 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 Aug 29, 2017; 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.