Individual provider Active NPI

Michelle Newman

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1225912108
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31127 Issued in MN
Practice address
621 W Lake St Ste 350
Minneapolis, MN 55408-2952
Phone
(612) 979-2276
Fax
(651) 925-0427
NPI assigned
Aug 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 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 31127 MN Primary

Addresses

Primary practice location

621 W Lake St Ste 350
Minneapolis, MN 55408-2952

Mailing address

3932 23Rd Ave S
Minneapolis, MN 55407-3039
Phone (612) 987-3365

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
I20260113000940 MN Practitioner - Clinical Social Worker 7911483615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virta Therapy Collective LLCGroup PAC ID 7618418260, 10 clinicians

Practice addresses (Care Compare)

209 Snelling Ave N
Saint Paul, MN 55104-6326
Phone (608) 709-8986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31127MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince Oct 13, 2025 Accepting new patients

Locations

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

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": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1225912108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3932 23RD AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073039",
            "telephone_number": "612-987-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W LAKE ST STE 350",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082952",
            "telephone_number": "612-979-2276",
            "fax_number": "651-925-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.