Angela Marie Carlson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21884 Issued in MN

Practice address

603 Bruce St
Crookston, MN 56716-2914

Phone

(218) 281-3940

Fax

(218) 281-6261

NPI assigned

May 2, 2016

Last updated

May 2, 2016By the provider in NPPES

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

• Angela Marie Gerding Former 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alluma, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Crookston, MN
  • NPI 1508835133
  Medicare reassignment NPD

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1134574726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567160603",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940",
            "fax_number": "218-281-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "GERDING",
            "middle_name": "MARIE",
            "credential": "LGSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danell Sue Burgess
• Beth Hariette Burnette
• Oliver Buseth, LADC
• Shanon Erin Caillier, CNP
• Calming Waters Therapy PLLC
• Jeanette Diane Carlson
• Mary Lou Carlson
• Eileen M Channel, CRNA
• Brynn Lara Charlesworth, M.D.
• Ioan John Chitu I

• Clinical Social Worker in Crookston, MN
• Providers in Crookston, 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 May 2, 2016; 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.