Individual provider Active NPI

Johannah Mariah Freund, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1174400188
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30138 Issued in MN
Practice address
345 Smith Ave N
Saint Paul, MN 55102-2346
Phone
(651) 220-6000
NPI assigned
Aug 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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 30138 MN Primary

Addresses

Primary practice location

345 Smith Ave N
Saint Paul, MN 55102-2346

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Other names 1

  • Johannah Mariah Schmidt Former name

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
I20251230003118 MN Practitioner - Clinical Social Worker 2264928167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
1309 Ms 21110Q
Minneapolis, MN 55440-1309

PO Box
Suite 1309
Minneapolis, MN 55440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30138MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Nov 26, 2025 Accepting new patients
Park Nicollet Clinic CurrentSince Nov 26, 2025 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 3

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": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1174400188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346",
            "telephone_number": "651-220-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Excelsior Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554264702",
            "country_code": "US",
            "telephone_number": "952-993-3123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREUND",
        "first_name": "JOHANNAH",
        "middle_name": "MARIAH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNAH",
            "last_name": "SCHMIDT",
            "middle_name": "MARIAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.