Individual provider Active NPI

Jennifer M Carlson, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1205790862
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10227 Issued in MN
Practice address
2215 E Lake St FL 5
Minneapolis, MN 55407-4385
Phone
(612) 596-9438
NPI assigned
Dec 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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 10227 MN Primary

Addresses

Primary practice location

2215 E Lake St FL 5
Minneapolis, MN 55407-4385

Mailing address

2215 E Lake St FL 5
Minneapolis, MN 55407-4385

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
I20251226001332 MN Practitioner - Clinical Social Worker 9234625476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9600 Aldrich Ave S
MC 658
Bloomington, MN 55420-0658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Feb 1, 2026 Accepting new patients
Hennepin County Clinical CurrentSince Feb 1, 2026 Accepting new patients

Locations

2215 E Lake St
Fl 5
Minneapolis, MN 55407
Phone (612) 543-2298

2215 E Lake St
Minneapolis, MN 55407
Phone (612) 596-0900

Organizations & group practices 2

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": "1765238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1205790862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 E LAKE ST FL 5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E LAKE ST FL 5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074385",
            "telephone_number": "612-596-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-09",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.