Individual provider Active NPI

Judith Ann Elling Przybilla, LICSW

  • Clinical Social Worker
  • Pipestone, MN
National Provider Identifier
1285334664
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
916 4TH Ave SW
Pipestone, MN 56164-1890
Phone
(507) 825-7512
NPI assigned
Mar 6, 2023
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 Primary

Addresses

Primary practice location

916 4TH Ave SW
Pipestone, MN 56164-1890

Mailing address

2257 110TH St
Balaton, MN 56115-3120
Phone (952) 288-7516

Other practice location 1

104 W Redwood St
Marshall, MN 56258-1980
Phone (507) 944-1557

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
I20231226001528 MN Practitioner - Clinical Social Worker 9830549351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 W Redwood St
Marshall, MN 56258-1980
Phone (507) 944-1557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Winds Counseling Clinical CurrentSince Nov 10, 2023 Accepting new patients

Locations

104 W Redwood St
Marshall, MN 56258
Phone (507) 532-2655

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1285334664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 110TH ST",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "561153120",
            "telephone_number": "952-288-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 4TH AVE SW",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561641890",
            "telephone_number": "507-825-7512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 W Redwood St",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MN",
            "postal_code": "562581980",
            "country_code": "US",
            "telephone_number": "507-944-1557",
            "fax_number": "507-607-8717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLING PRZYBILLA",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pipestone, MN

Sources for this page

Verify at the official NPI Registry.