Allisen Deville, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28139 Issued in MN

Practice address

800 Minnehaha Ave E # 400
Saint Paul, MN 55106-4437

Phone

(651) 808-1989

NPI assigned

Jul 5, 2021

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1912315144
  NPD

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1093386690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 COUNTY ROAD B2 E APT 306",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171507",
            "telephone_number": "651-808-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MINNEHAHA AVE E # 400",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551064437",
            "telephone_number": "651-808-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVILLE",
        "first_name": "ALLISEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-05",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Dettle
• Kristin M Dettmer, APRN
• Irene Carolyn Detviler, RN
• Andrea Elizabeth Deuring, LPCC
• Swapna Devanna, MD
• Brian John Devoe, DDS
• Heather Ann Devoe
• Amanda Devoogdt, CPM
• Madeline Devore, BCABA
• Jason Matthew Devries, M.D.

• 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 Aug 27, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.