Jerrion Andrew Richardson, MSSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23353 Issued in MN

Practice address

1614 Harmon PL Ste 230
Minneapolis, MN 55403-1929

Phone

(612) 354-2592

NPI assigned

Jul 16, 2017

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  Medicare reassignment NPD
• Reed & Ember PLLC

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1093391096
  NPD Authorized official
• Medicine Lake Consultation Group,PLLC

  • Psychiatry Physician
  • St Louis Park, MN
  • NPI 1881753564
  NPD

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

{
    "created_epoch": "1500163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651276800000",
    "number": "1225550791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 3RD ST NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554212128",
            "telephone_number": "612-354-2592",
            "fax_number": "612-474-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 HARMON PL STE 230",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554031929",
            "telephone_number": "612-354-2592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4027 County Road 25",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "55416",
            "country_code": "US",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 Ford Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "55426",
            "country_code": "US",
            "telephone_number": "952-378-1800",
            "fax_number": "952-378-1714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JERRION",
        "middle_name": "ANDREW",
        "credential": "MSSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-16",
        "last_updated": "2022-04-30",
        "certification_date": "2022-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria L Richards
• Chad Richardson, MD
• Conor Alexander Richardson, MD
• Dawhon R Richardson
• Jenna Richardson
• M. Reuben Richardson, CRNA
• Melissa Richardson, PA-C
• Portia Richardson, L.AC.
• Ryan Richardson, MD
• Stephen Richardson, M.D.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Apr 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.