Angela Michelle Brust, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19237 Issued in MN

Practice address

5200 Willson Rd Ste 307
Edina, MN 55424-1344

Phone

(612) 405-5565

NPI assigned

Mar 20, 2011

Last updated

Mar 4, 2021By the provider in NPPES

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

Other names 1

• Angela Michelle Holmberg 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

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Angela Brust, LLC

  • Clinical Social Worker
  • Edina, MN
  • NPI 1023627593
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1300579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1093014870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 307",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241344",
            "telephone_number": "612-405-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 307",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241344",
            "telephone_number": "612-405-5565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Park Nicollet Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554162527",
            "country_code": "US",
            "telephone_number": "952-993-3307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUST",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-20",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "HOLMBERG",
            "middle_name": "MICHELLE",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul F Bruer, MD
• Deidra Brueske
• Stephanie Bruggman, OTR
• Gary L Brunkow, MD
• Jeffrey Eric John Brunsgaard
• Roy Gordon Bryan, MD
• Carol Thomas Bryant, AU.D.
• Jennifer Elizabeth Bryant, MD
• Leah Brzezinski
• Stephen M Brzica Jr., MDA

• Clinical Social Worker in Edina, MN
• Providers in Edina, 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 4, 2021; 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.