Active NPI
David Stern, LICSW
- Clinical Social Worker
- Alexandria, MN
National Provider Identifier
1235358037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7483
- Practice address
- 4133 Iowa St
Alexandria, MN 56308-3316 - Phone
- (320) 762-8851
- Fax
- (651) 925-0057
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7483 | MN | Primary |
| Psychologist | 103T00000X | 1449 | MN |
Addresses
Primary practice location
4133 Iowa St
Alexandria, MN 56308-3316
Mailing address
PO Box 9859
Fargo, ND 58106-9859
Phone (701) 451-4900
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56308-A004 | Other | MN | TRI WEST |
| 522853100 | Medicaid | MN | |
| 62-70233 | Other | MN | MEDICA UBH |
| 31002005 | Other | MN | PRIMEWEST |
| 06H9ST | Other | MN | BCBS MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7483 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Family Service Center | Past | Accepting new patients | |
| Village Family Service Center | Clinical | Past | Accepting new patients |
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.
-
dba The Village Family Service Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fargo, ND
- NPI 1568492353
Clinical
-
dba The Village Family Service Center
- Substance Abuse Rehabilitation Facility
- Fargo, ND
- NPI 1952679318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1235358037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9859",
"city": "FARGO",
"state": "ND",
"postal_code": "581069859",
"telephone_number": "701-451-4900",
"fax_number": "651-925-0057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4133 IOWA ST",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563083316",
"telephone_number": "320-762-8851",
"fax_number": "651-925-0057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERN",
"first_name": "DAVID",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "7483",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "1449",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRI WEST",
"identifier": "56308-A004",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "522853100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA UBH",
"identifier": "62-70233",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIMEWEST",
"identifier": "31002005",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN",
"identifier": "06H9ST",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.