Individual provider Active NPI

Jennifer Lynn Schuette, LICSW

  • Clinical Social Worker
  • Burnsville, MN
National Provider Identifier
1265503502
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW-16048 Issued in MN
Practice address
14551 Judicial Rd Ste 100
Burnsville, MN 55306-4991
Phone
(952) 898-5020
Fax
(952) 898-5858
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 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 LICSW-16048 MN Primary

Addresses

Primary practice location

14551 Judicial Rd Ste 100
Burnsville, MN 55306-4991

Mailing address

14551 Judicial Rd Ste 100
Burnsville, MN 55306-4991
Phone (952) 898-5020

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
I20070717000298 MN Practitioner - Clinical Social Worker 0143320374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Bushman Psychological Services LLCGroup PAC ID 8820994668, 11 clinicians

Practice addresses (Care Compare)

14551 Judicial Rd
Suite 100
Burnsville, MN 55306-4991
Phone (952) 898-5020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW-16048MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bushman Psychological Services LLC CurrentSince Jun 1, 2007 Accepting new patients

Locations

14551 Judicial Rd
Ste 100
Burnsville, MN 55306
Phone (952) 898-5020

1755 Southcross Dr W
Burnsville, MN 55306
Phone (952) 898-5020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1265503502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14551 JUDICIAL RD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064991",
            "telephone_number": "952-898-5020",
            "fax_number": "952-898-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14551 JUDICIAL RD STE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553064991",
            "telephone_number": "952-898-5020",
            "fax_number": "952-898-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUETTE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "LICSW-16048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.