Individual provider Active NPI

Michelle Carter, LICSW

  • Clinical Social Worker
  • Roseville, MN
National Provider Identifier
1285250399
Registry record updated Sep 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9849 Issued in MN
Practice address
2652 Mackubin St
Roseville, MN 55113-2339
Phone
(612) 224-5779
NPI assigned
Jun 24, 2020
Last updated
Sep 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9849 MN Primary
Clinical Social Worker 1041C0700X 9729-123 WI

Addresses

Primary practice location

2652 Mackubin St
Roseville, MN 55113-2339

Mailing address

2652 Mackubin St
Roseville, MN 55113-2339
Phone (612) 224-5779

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
I20201215001563 MN Practitioner - Clinical Social Worker 9638581762 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9729-123WIMDClinical Social Worker
9849MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Single Specialty Current Accepting new patients
Range Regional Health Services Single Specialty CurrentSince Sep 15, 2025 Accepting new patients
Fairview Express Care CurrentSince Oct 2, 2020 Accepting new patients
Range Regional Health Services CurrentSince Sep 15, 2025 Accepting new patients
Mental Health Specialty Group PA Single Specialty CurrentSince Aug 1, 2025 Accepting new patients
Fairview Express Care Single Specialty CurrentSince Oct 2, 2020 Accepting new patients

Locations

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

729 Washington Ave N
Ste 600
Minneapolis, MN 55401
Phone (334) 463-3099

402 E Platt Ave
Nashwauk, MN 55769
Phone (218) 885-2858

Organizations & group practices 6

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759017600000",
    "number": "1285250399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2652 MACKUBIN ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132339",
            "telephone_number": "612-224-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2652 MACKUBIN ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132339",
            "telephone_number": "612-224-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MICHELLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2025-09-28",
        "certification_date": "2025-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9849",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9729-123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.