Individual provider Active NPI

Seth Johnson, MSW, LICSW

  • Clinical Social Worker
  • Willmar, MN
National Provider Identifier
1225759285
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28559 Issued in MN
Practice address
1125 6TH St SE
Willmar, MN 56201-4675
Phone
(320) 235-4611
NPI assigned
Sep 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 28559 MN Primary

Addresses

Primary practice location

1125 6TH St SE
Willmar, MN 56201-4675

Mailing address

1125 6TH St SE
Willmar, MN 56201-4675

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
I20220924000180 MN Practitioner - Clinical Social Worker 0941685127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

1125 SE 6TH St
Willmar, MN 56201-4675
Phone (320) 235-4613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Centers CurrentSince Sep 12, 2022 Accepting new patients

Locations

1125 6th St SE
Willmar, MN 56201
Phone (320) 231-9148

Organizations & group practices 1

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1225759285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014675",
            "telephone_number": "320-235-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SETH",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.