Active NPI
Angelina Mae Rudningen, MSW/LICSW
- Clinical Social Worker
- New London, MN
National Provider Identifier
1205348729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16958
- Practice address
- 4544 189TH Ave NW
New London, MN 56273-9436 - Phone
- (320) 905-0919
- NPI assigned
- Oct 25, 2017
- 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 | 16958 | MN | Primary |
Addresses
Primary practice location
4544 189TH Ave NW
New London, MN 56273-9436
Mailing address
1305 1St St S
Willmar, MN 56201-4236
Phone (320) 231-2737
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16958 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1205348729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 1ST ST S",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562014236",
"telephone_number": "320-231-2737",
"fax_number": "320-441-7005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4544 189TH AVE NW",
"city": "NEW LONDON",
"state": "MN",
"postal_code": "562739436",
"telephone_number": "320-905-0919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDNINGEN",
"first_name": "ANGELINA",
"middle_name": "MAE",
"credential": "MSW/LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-25",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "16958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.