Stephanie A Bumgardner, M.S.W., L.I.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16568 Issued in MN

Practice address

1526 30TH St NW
Bemidji, MN 56601-4140

Phone

(218) 751-0887

Fax

(218) 759-4807

NPI assigned

Apr 24, 2009

Last updated

Mar 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Therapy and Consulting, LLC

  • Clinical Social Worker
  • Bemidji, MN
  • NPI 1972350312
  NPD
• North Homes, Inc.

  dba North Homes Children and Family Services

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1790826550

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1306080197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014140",
            "telephone_number": "218-751-0887",
            "fax_number": "218-759-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014140",
            "telephone_number": "218-751-0887",
            "fax_number": "218-759-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARDNER",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "M.S.W., L.I.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "16568",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Kirsten Bruder
• Jacia Lynn Andrews Bruns, PHARMD
• Robin Leach Buchanan, APRN
• Daneane Rae Budreau, BS
• Lauren Marie Buie, MSW
• Patricia K Burdick, PA-C
• McKenzi Karen Burmeister, MD
• Shawna Marie Burnham, LICSW
• Olivia Erin Caccia
• Benjamin Brandon Patrick Cahill, CHW

• 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 Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.