Individual provider Active NPI

Sharlene May Santmyer, MSW, LICSW

  • Clinical Social Worker
  • Cloquet, MN
National Provider Identifier
1245816701
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26252 Issued in MN
Practice address
1102 Cloquet Ave
Cloquet, MN 55720-1620
Phone
(218) 499-7000
Fax
(218) 499-7001
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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 26252 MN Primary

Addresses

Primary practice location

1102 Cloquet Ave
Cloquet, MN 55720-1620

Mailing address

1102 Cloquet Ave
Cloquet, MN 55720-1620
Phone (218) 499-7000

Other practice location 1

4328 E Superior St
Duluth, MN 55804-2177
Phone (218) 499-7000

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
I20211115000465 MN Practitioner - Clinical Social Worker 8527457464 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
Telehealth
Offers telehealth services
Group practices
Birch and Pine Counseling PLLPGroup PAC ID 9436525482, 5 clinicians

Practice addresses (Care Compare)

1618 Cloquet Ave
Cloquet, MN 55720-1948
Phone (218) 451-2116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26252MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Birch & Pine Counseling PLLP Clinical CurrentSince Aug 10, 2022 Accepting new patients
Brightwater Health Dba Human Development Center PastSince Mar 28, 2021 Accepting new patients

Locations

1618 Cloquet Ave
Cloquet, MN 55720
Phone (218) 451-2116

501 S Lake Ave
Duluth, MN 55802

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1245816701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201620",
            "telephone_number": "218-499-7000",
            "fax_number": "218-499-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201620",
            "telephone_number": "218-499-7000",
            "fax_number": "218-499-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4328 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558042177",
            "country_code": "US",
            "telephone_number": "218-499-7000",
            "fax_number": "218-499-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTMYER",
        "first_name": "SHARLENE",
        "middle_name": "MAY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.