Julia May Carpenter, MSW
Individual provider Active NPI Clinical Social Worker · Wayzata, MN
NPI 1194486704 · NPPES record last updated Apr 15, 2024
Key facts
- NPI
- 1194486704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 33179 (MN)
- Practice address
- 1120 Wayzata Blvd E Ste 210
Wayzata, MN 55391-1915 - Phone
- (952) 443-4600
- NPI assigned
- Jan 5, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240513001315 | MN | Practitioner - Clinical Social Worker | 7113368895 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33179 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Brecke Counseling Group | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 33179 | MN | Yes |
Addresses
Primary practice location
1120 Wayzata Blvd E Ste 210
Wayzata, MN 55391-1915
Mailing address
2350 Brookpoint LN
Stevensville, MI 49127-1309
Phone (312) 989-7571
Other providers in Wayzata, MN
- Brooke Carlson
- Jolene Margaret Carlson
- Tara Carlson
- Katherine Ann Carosella
- Christa Marie Carpenter
- Kara Carper
- Robert Collins Cavender Jr.
- CGPS, Inc
- Emily Parker Chapman
- Susan Chargo
All providers in Wayzata, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.