Branden David Phillips, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19935 Issued in MN

Practice address

3241 Scott Ave N
Golden Valley, MN 55422-2745

Phone

(952) 322-0836

NPI assigned

Jan 4, 2016

Sex

Male

Sole proprietor

No

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 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

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.

• Open Door Mental Health Services, Inc

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1306632633
  Medicare reassignment NPD Authorized official
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1215393483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 SCOTT AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554222745",
            "telephone_number": "952-322-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 SCOTT AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554222745",
            "telephone_number": "952-322-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BRANDEN",
        "middle_name": "DAVID",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Peterson, OTR/L
• Paul William Peterson, D.D.S.
• Nicole Lynn Pfeffer, COTA/L
• Lucinda S Phair, RN MA MSCN
• Mara Pham, NP
• Jeannine Pamela Phillips, PA-C
• Stephanie Anne Pickthorn
• Pillpack LLC (Amazon Pharmacy #013)
• Marilyn Pineo
• Nikole Allyce Pitman, LPCC

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.