Juliana Renee Robertson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27882 Issued in MN

Practice address

24760 Hospital Dr
Redlake, MN 56671

Phone

(218) 679-0168

Fax

(218) 679-0187

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MN2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHS Indian HospitalGroup PAC ID 4789598731, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Red Lake Hospital Hospital, Redlake, MN, CCN 240206

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 and National Provider Directory roles.

• PHS Indian Hospital

  • General Acute Care Hospital
  • Red Lake, MN
  • NPI 1508809765

  Single Specialty, TX

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, MN

  Medicare reassignment NPD
• PHS Indian Hospital

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Red Lake, MN
  • NPI 1063549822
  Care Compare group

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1194449249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3578 KIMMUR RD SW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015821",
            "telephone_number": "507-319-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24760 HOSPITAL DR",
            "city": "REDLAKE",
            "state": "MN",
            "postal_code": "56671",
            "telephone_number": "218-679-0168",
            "fax_number": "218-679-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JULIANA",
        "middle_name": "RENEE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Red Lake Chemical Health Treatment Center
• Red Lake Comprehensive Health Services
• Red Lake Comprehensive Health Services
• Red Lake Department of Family and Children Services
• Redlake Chemical Health Program Group Home
• Beth A Schmid, RDH
• Saunda St Martin, NP, APRN
• Federico Pascual Tinsay, MD, FAAP

• All providers in Redlake, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.