Individual provider Active NPI

Annmarie Kay Florest, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1275890980
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16526 Issued in MN
Practice address
2120 Park Ave
Minneapolis, MN 55404-3378
Phone
(612) 872-2000
Fax
(612) 871-1375
NPI assigned
Apr 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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 16526 MN Primary

Addresses

Primary practice location

2120 Park Ave
Minneapolis, MN 55404-3378

Mailing address

3729 Snelling Ave Apt 204
Minneapolis, MN 55406-2608
Phone (612) 799-6641

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
I20120718000173 MN Practitioner - Clinical Social Worker 3274799390 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16526MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Range Mental Health Center CurrentSince Dec 31, 2018 Accepting new patients

Locations

624 13th St S
Virginia, MN 55792
Phone (218) 749-2881

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": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1275890980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3729 SNELLING AVE APT 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062608",
            "telephone_number": "612-799-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043378",
            "telephone_number": "612-872-2000",
            "fax_number": "612-871-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOREST",
        "first_name": "ANNMARIE",
        "middle_name": "KAY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.