Elijah Wood, DSW, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28914 Issued in MN

Practice address

15265 Carrousel Way Ste 100
Rosemount, MN 55068-1760

Phone

(952) 443-4600

NPI assigned

Mar 21, 2023

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Fern Counseling PLLC

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1790356186
  Medicare reassignment

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1235831322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15265 CARROUSEL WAY STE 100",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15265 CARROUSEL WAY STE 100",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681760",
            "telephone_number": "952-443-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "ELIJAH",
        "credential": "DSW, MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Wilson
• Winters Pediatric Dentistry, PLLC
• Kerry Gwen Johnson Winters, DDS
• Madalynn Winters
• Breana Witte, CCC-SLP
• Mindy S Worden
• Melissa Worm
• Lauren Yares
• Hailey Ziemer

• Clinical Social Worker in Rosemount, MN
• Providers in Rosemount, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.