Jolene Marie Metcalf, LICSW

Individual provider Active NPI Clinical Social Worker · Centerville, MN

NPI 1295499192 · NPPES record last updated Oct 26, 2021

Key facts

NPI
1295499192
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
17628 (MN)
Practice address
7039 20TH Ave
Centerville, MN 55038-9737
Phone
(651) 288-0332
Fax
(651) 288-0493
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerlife Counseling LLC (13 clinicians)

Practice addresses (Care Compare)

7039 20TH Ave
Centerville, MN 55038-9737
Phone 6512880332131

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20211229001361 MN Practitioner - Clinical Social Worker 9234520271 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Centerlife Counseling, LLC Clinical Current
since Oct 20, 2021
Accepting new patients

Locations

7039 20th Ave
Hugo, MN 55038
Phone (651) 288-0332

4444 Centerville Rd
Ste 235
White Bear Lake, MN 55127
Phone (651) 289-3111

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17628 MN Yes

Addresses

Primary practice location

7039 20TH Ave
Centerville, MN 55038-9737

Mailing address

2018 Dale St N
Roseville, MN 55113-6476
Phone (651) 278-2251

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address jmetcalf@centerlifecounseling.com Direct

Other providers in Centerville, MN

All providers in Centerville, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.