Individual provider Active NPI

Nicole Ness, LICSW

  • Clinical Social Worker
  • Breckenridge, MN
National Provider Identifier
1164056131
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29136 Issued in MN
Practice address
810 Beede Ave
Breckenridge, MN 56520-1660
Phone
(701) 866-9089
NPI assigned
Feb 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 29136 MN Primary

Addresses

Primary practice location

810 Beede Ave
Breckenridge, MN 56520-1660

Mailing address

528 11TH Ave N
Moorhead, MN 56560-1579
Phone (701) 866-9089

Other practice location 1

710 13th St N
Breckenridge, MN 56520-1317
Phone (701) 866-9089

Other practice location 2

528 11th Ave N
Moorhead, MN 56560-1579
Phone (701) 866-9089

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
I20220910000655 MN Practitioner - Clinical Social Worker 0547645608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ness Counseling P.L.L.C. Clinical CurrentSince Jan 1, 2025 Accepting new patients

Locations

810 Beede Ave
Breckenridge, MN 56520
Phone (218) 643-6822

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1164056131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 11TH AVE N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565601579",
            "telephone_number": "701-866-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 BEEDE AVE",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201660",
            "telephone_number": "701-866-9089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 13th St N",
            "address_purpose": "LOCATION",
            "city": "Breckenridge",
            "state": "MN",
            "postal_code": "565201317",
            "country_code": "US",
            "telephone_number": "701-866-9089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "528 11th Ave N",
            "address_purpose": "LOCATION",
            "city": "Moorhead",
            "state": "MN",
            "postal_code": "565601579",
            "country_code": "US",
            "telephone_number": "701-866-9089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESS",
        "first_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, MN

Sources for this page

Verify at the official NPI Registry.