Fierra Megan Nussbaum, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27427 Issued in MN

Practice address

149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238

Phone

(651) 450-0860

Fax

(651) 450-0759

NPI assigned

Oct 31, 2018

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

Other names 1

• Fjaere Megan Harder Nussbaum Other 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

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.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  Medicare reassignment NPD

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1104393883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 THOMPSON AVE E STE 150",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183238",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "FIERRA",
        "middle_name": "MEGAN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FJAERE",
            "last_name": "HARDER NUSSBAUM",
            "middle_name": "MEGAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Madeline Alesca North, LPCC
• Northland Dental Partners, PLLC
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• Optometric Services, LLC.
• Emma S Ostby, MD
• Megan Paulsen
• Theresa Joan Pavek

• Clinical Social Worker in West St Paul, MN
• Providers in West St 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 Apr 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.