Individual provider Active NPI

Julia Hutchinson, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1114662665
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24463 Issued in MN
Practice address
541 Selby Ave
Saint Paul, MN 55102-1728
Phone
(612) 877-1606
NPI assigned
Apr 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24463 MN Primary

Addresses

Primary practice location

541 Selby Ave
Saint Paul, MN 55102-1728

Mailing address

521 2ND St SE Apt 301
Minneapolis, MN 55414-2299
Phone (612) 877-1606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 22, 2024 through Jan 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24463MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1114662665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 2ND ST SE APT 301",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142299",
            "telephone_number": "612-877-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021728",
            "telephone_number": "612-877-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "JULIA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.