Active NPI
Anthony Warren Hunniutt, LSW LAOC LICENSED SO
- Social Worker
- Fridley, MN
National Provider Identifier
1114096724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 12707
- Practice address
- 7590 Lyric Lane NE
Fridley, MN 55432 - Phone
- (763) 236-4509
- Fax
- (763) 236-4370
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 301004 | MN | |
| Social Worker | 104100000X | 12707 | MN | Primary |
Addresses
Primary practice location
7590 Lyric Lane NE
Fridley, MN 55432
Mailing address
1525 121St Ave NW
Coon Rapids, MN 55448
Phone (763) 754-6696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301004 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 12707 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1114096724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 121ST AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "55448",
"telephone_number": "763-754-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7590 LYRIC LANE NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "55432",
"telephone_number": "763-236-4509",
"fax_number": "763-236-4370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNNIUTT",
"first_name": "ANTHONY",
"middle_name": "WARREN",
"name_prefix": "Mr.",
"credential": "LSW LAOC LICENSED SO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "301004",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "12707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.