Individual provider Active NPI

Jennifer Reddig, MSW, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1285202242
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29084 Issued in MN
Practice address
1919 University Ave W Ste 6
Saint Paul, MN 55104-3435
Phone
(612) 444-1589
NPI assigned
Jun 16, 2021
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 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 29084 MN Primary

Addresses

Primary practice location

1919 University Ave W Ste 6
Saint Paul, MN 55104-3435

Mailing address

7393 51St St N
Oakdale, MN 55128-2291
Phone (612) 444-1589

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
I20230710000941 MN Practitioner - Clinical Social Worker 6305205303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways Counseling Center IncGroup PAC ID 0941669576, 6 clinicians

Practice addresses (Care Compare)

1919 University Ave W
Suite 6
St Paul, MN 55104-3453
Phone (651) 641-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling Center, Inc. CurrentSince May 5, 2023 Accepting new patients

Locations

1919 University Ave W
Ste 6
Saint Paul, MN 55104
Phone (651) 641-1555

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1285202242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7393 51ST ST N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551282291",
            "telephone_number": "612-444-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W STE 6",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043435",
            "telephone_number": "612-444-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDIG",
        "first_name": "JENNIFER",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.