Active NPI
Jennifer Lynn Chasco, LICSW
- Clinical Social Worker
- Coon Rapids, MN
National Provider Identifier
1194271361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 22635
- Practice address
- 1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433 - Phone
- (763) 427-7964
- Fax
- (763) 427-7976
- NPI assigned
- Aug 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 22635 | MN | Primary |
Addresses
Primary practice location
1930 Coon Rapids Blvd NW
Coon Rapids, MN 55433
Mailing address
2060 Centre Pointe Blvd Ste 3
Saint Paul, MN 55120-1271
Phone (651) 288-3521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22635 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554163200000",
"number": "1194271361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2060 CENTRE POINTE BLVD STE 3",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551201271",
"telephone_number": "651-288-3521",
"fax_number": "651-774-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 COON RAPIDS BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "55433",
"telephone_number": "763-427-7964",
"fax_number": "763-427-7976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASCO",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-29",
"last_updated": "2019-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "22635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.