Individual provider Active NPI

Noah Julian Simcox, LICSW

  • Clinical Social Worker
  • Saint Louis Park, MN
National Provider Identifier
1134448590
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13805 Issued in MN
Practice address
4021 Vernon Ave S Ste 306
Saint Louis Park, MN 55416-2816
Phone
(651) 646-2326
NPI assigned
May 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 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 13805 MN Primary

Addresses

Primary practice location

4021 Vernon Ave S Ste 306
Saint Louis Park, MN 55416-2816

Mailing address

3843 Glenhurst Ave
St Louis Park, MN 55416-4915
Phone (651) 646-2326

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111219000685 MN Practitioner - Clinical Social Worker 7618142761 Practice locations: Saint Paul, MN; St Louis Park, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4021 Vernon Ave S
Suite 306
St Louis Park, MN 55416-2816
Phone (651) 646-2326

750 Mississippi River Blvd S
Saint Paul, MN 55116-1006
Phone (651) 698-1111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13805MNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1134448590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 GLENHURST AVE",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164915",
            "telephone_number": "651-646-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 VERNON AVE S STE 306",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162816",
            "telephone_number": "651-646-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMCOX",
        "first_name": "NOAH",
        "middle_name": "JULIAN",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-25",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis Park, MN

Sources for this page

Verify at the official NPI Registry.