Individual provider Active NPI

Rebecca Nosbusch, MSW, LICSW

  • Clinical Social Worker
  • Estherville, IA
National Provider Identifier
1235760125
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26767 Issued in MN
Practice address
1801 E Central Ave
Estherville, IA 51334
Phone
(800) 592-0180
NPI assigned
Jan 29, 2020
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 26767 MN Primary

Addresses

Primary practice location

1801 E Central Ave
Estherville, IA 51334

Mailing address

72319 570TH Ave
Jackson, MN 56143-3266
Phone (507) 350-1339

Other practice location 1

72319 570th Ave
Jackson, MN 56143-3266
Phone (507) 350-1339

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.championmind.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200804001134 IA Practitioner - Clinical Social Worker 6709202443 Reassigns benefits to 1 organization
I20250314002328 MN Practitioner - Clinical Social Worker 6709202443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Mental Health Center IncGroup PAC ID 7012816812, 16 clinicians

Practice addresses (Care Compare)

1210 5TH Ave
Worthington, MN 56187-2432
Phone (507) 376-4141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26767MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Mental Health Center Inc CurrentSince Mar 1, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1235760125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72319 570TH AVE",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561433266",
            "telephone_number": "507-350-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E CENTRAL AVE",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "51334",
            "telephone_number": "800-592-0180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72319 570th Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MN",
            "postal_code": "561433266",
            "country_code": "US",
            "telephone_number": "507-350-1339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOSBUSCH",
        "first_name": "REBECCA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.championmind.org",
            "affiliation": "N",
            "address_1": "1801 e central ave",
            "city": "estherville",
            "state": "IA",
            "country_code": "US",
            "postal_code": "51334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Estherville, IA

Sources for this page

Verify at the official NPI Registry.