Brianne Wallgren, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23400 Issued in MN

Practice address

122 Case Ave
Saint Paul, MN 55117-5049

Phone

(218) 780-7931

NPI assigned

Oct 27, 2023

Sex

Female

Sole proprietor

Yes

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neighborhood HealthsourceGroup PAC ID 9133199953, 16 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.

• Neighborhood Healthsource

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1386682078
  Medicare reassignment Care Compare group NPD
• Neighborhood Healthsource

  • Federally Qualified Health Center (FQHC)
  • Coon Rapids, MN
  • NPI 1659323459
  NPD
• Howry Residential Service

  • Foster Care Agency
  • Mendota Heights, MN
  • NPI 1801151758
  NPD (past)

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1083486468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 CENTRE POINTE CURV",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201264",
            "telephone_number": "651-917-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CASE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551175049",
            "telephone_number": "218-780-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLGREN",
        "first_name": "BRIANNE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret A Wallenfriedman, MD
• Mara Waller
• Sarah Waller, MSW, LICSW
• Steven Waller, MD
• Kristen Kay Wallets, FNP
• Linda L Walling, MD
• Anders Wallock, MOT, OTR/L
• Cindy Walsh, LPC
• Colleen R Walsh, ANP
• Danielle Walsh, RN, PHN

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 Oct 27, 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.
• 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.