Individual provider Active NPI

Gina Lynn Misiewicz, LICSW

  • Clinical Social Worker
  • Robbinsdale, MN
National Provider Identifier
1154957439
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21761 Issued in MN
Practice address
3300 Oakdale Avenue N
Robbinsdale, MN 55422
Phone
(763) 581-5372
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 21761 MN
Clinical Social Worker 1041C0700X 21761 MN Primary

Addresses

Primary practice location

3300 Oakdale Avenue N
Robbinsdale, MN 55422

Mailing address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2900
Phone (763) 581-5372

Other practice location 1

1250 W Broadway Ave
Minneapolis, MN 55411-2533
Phone (612) 668-2883

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
I20200519001848 MN Practitioner - Clinical Social Worker 6800227265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21761MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Memorial Health Care CurrentSince May 1, 2020 Accepting new patients
North Memorial Health Care Current Accepting new patients

Locations

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

15450 Highway 7
Ste 225
Minnetonka, MN 55345
Phone (612) 756-8008

3366 Oakdale Ave N
Ste 315
Robbinsdale, MN 55422
Phone (763) 520-7900

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1154957439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222900",
            "telephone_number": "763-581-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVENUE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-581-5372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 W Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554112533",
            "country_code": "US",
            "telephone_number": "612-668-2883",
            "fax_number": "612-668-2880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISIEWICZ",
        "first_name": "GINA",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MN",
            "license": "21761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.