Active NPI
Beth Ellen Feikema Breen, LICSW
- Clinical Social Worker
- Saint Paul, MN
National Provider Identifier
1235452426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2063
- Practice address
- 1345 Summit Ave
Saint Paul, MN 55105-2219 - Phone
- (651) 464-2194
- NPI assigned
- Mar 2, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2063 | MN | Primary |
Addresses
Primary practice location
1345 Summit Ave
Saint Paul, MN 55105-2219
Mailing address
1068 Lake St S
#12
Forest Lake, MN 55025-2639
Phone (651) 464-2194
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakes Area Human Services, Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Forest Lake, MN
- NPI 1700956646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1235452426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1068 LAKE ST S",
"address_2": "#12",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550252639",
"telephone_number": "651-464-2194",
"fax_number": "651-464-5744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 SUMMIT AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052219",
"telephone_number": "651-464-2194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEN",
"first_name": "BETH",
"middle_name": "ELLEN FEIKEMA",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-02",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "2063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.