Individual provider Active NPI

David Wesley Werner, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1083420954
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23841 Issued in MN
Practice address
219 SE Main St Ste 400
Minneapolis, MN 55414-2151
Phone
(612) 886-2524
Fax
(612) 886-2538
NPI assigned
Dec 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 23841 MN Primary

Addresses

Primary practice location

219 SE Main St Ste 400
Minneapolis, MN 55414-2151

Mailing address

219 SE Main St Ste 400
Minneapolis, MN 55414-2151
Phone (612) 886-2524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

219 SE Main St
Suite 400
Minneapolis, MN 55414-2151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23841MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Arch Psychology and Health Services CurrentSince Dec 8, 2024 Accepting new patients

Locations

219 SE Main St
Ste 400
Minneapolis, MN 55414
Phone (612) 379-2640

Organizations & group practices 1

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": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1083420954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 SE MAIN ST STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142151",
            "telephone_number": "612-886-2524",
            "fax_number": "612-886-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 SE MAIN ST STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142151",
            "telephone_number": "612-886-2524",
            "fax_number": "612-886-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "DAVID",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.