Laura Jane Mortenson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17010 Issued in MN

Practice address

2680 Snelling Ave N Ste 200
Roseville, MN 55113-1879

Phone

(651) 364-9381

NPI assigned

Oct 7, 2021

Sex

Female

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vantage Mental HealthGroup PAC ID 4587104815, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Vantage Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park Heights, MN
  • NPI 1538990288
  Medicare reassignment Care Compare group NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1255093258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 SNELLING AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131879",
            "telephone_number": "651-364-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 SNELLING AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131879",
            "telephone_number": "651-364-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "LAURA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharlyn Moravec, FNP-BC
• Joseph Patrick Morcomb, LPCC
• Jason Morgan
• Laura Anne Morrison, AUD CCCA
• James Albert Morse, D.C.
• Suzanne A Moseley, PHD
• Der Moua, RN
• Trevor Mox, OD
• Aaron Patrick Moyer, DPT
• Krista Mrozinski, LMFT

• Clinical Social Worker in Roseville, MN
• Providers in Roseville, 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 Oct 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.