Individual provider Active NPI

Brittney Wacek

  • Clinical Social Worker
  • Andover, MN
National Provider Identifier
1265058721
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1875 Station Pkwy NW
Andover, MN 55304-3319
Phone
(763) 482-9598
NPI assigned
Jun 21, 2020
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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 NU Primary

Addresses

Primary practice location

1875 Station Pkwy NW
Andover, MN 55304-3319

Mailing address

1875 Station Pkwy NW
Andover, MN 55304-3319

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
I20200728000132 MN Practitioner - Clinical Social Worker 3476977182 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
Rum River Counseling, IncGroup PAC ID 0941661482, 20 clinicians

Practice addresses (Care Compare)

1875 Station Pkwy NW
Andover, MN 55304-4259
Phone (763) 482-9598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rum River Counseling, Inc. Clinical CurrentSince Aug 4, 2023 Accepting new patients

Locations

1875 Station Pkwy NW
Andover, MN 55304

7200 Hudson Blvd N
Ste 220
Oakdale, MN 55128

18205 45th Ave N
Ste D
Plymouth, MN 55446
Phone (214) 554-4089

1619 Dayton Ave
Ste 201
Saint Paul, MN 55104
Phone (651) 645-5504

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, 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": "1592697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1265058721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043319",
            "telephone_number": "763-482-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACEK",
        "first_name": "BRITTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-21",
        "last_updated": "2023-09-12",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.