Violet Irene Sundermeyer, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17873 Issued in MN

Practice address

516 Beltrami Ave NW
Bemidji, MN 56601-3010

Phone

(218) 444-2847

Fax

(218) 444-2847

NPI assigned

Apr 8, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Birch Lake Counseling LLCGroup PAC ID 5496904971, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Birch Lake Counseling LLC

  • Clinic/Center
  • Hackensack, MN
  • NPI 1760646715
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1285877142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566190430",
            "telephone_number": "218-444-2845",
            "fax_number": "218-444-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 BELTRAMI AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013010",
            "telephone_number": "218-444-2847",
            "fax_number": "218-444-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERMEYER",
        "first_name": "VIOLET",
        "middle_name": "IRENE",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Stevens, RN, CRNA
• Heather M Stone, MPT
• Coralyn Elizabeth Strodtman, PHARMD
• Emily R Stromquist, M.D.
• Bryan David Styve, LADC
• Anita Florence Sundholm, C-FNP
• Lori Ann Sutherland, CRNA
• Shad Leroy Swanson, D.C.
• Jarad Syrstad, DPT
• Kaisa Syvaoja, DOT

• Clinical Social Worker in Bemidji, MN
• Providers in Bemidji, 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 Apr 8, 2009; 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.