Teresa Anne Conlan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21049 Issued in MN

Practice address

15 Interlachen Rd
Hopkins, MN 55343-8547

Phone

(651) 278-7764

NPI assigned

Feb 9, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

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, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1285025551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9044 KELL CIR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371811",
            "telephone_number": "651-278-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 INTERLACHEN RD",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438547",
            "telephone_number": "651-278-7764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9044 KELL CIR",
            "address_purpose": "LOCATION",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371811",
            "country_code": "US",
            "telephone_number": "651-278-7764",
            "fax_number": "503-507-5308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7831 E Bush Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554393118",
            "country_code": "US",
            "telephone_number": "651-278-7764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLAN",
        "first_name": "TERESA",
        "middle_name": "ANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7012",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Hopkins, MN
• Providers in Hopkins, 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 May 25, 2023; 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.