Individual provider Active NPI

Tina Marie Dince, LICSW

  • Clinical Social Worker
  • Stillwater, MN
National Provider Identifier
1306398599
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21704 Issued in MN
Practice address
1875 Northwestern Ave S
Stillwater, MN 55082-7534
Phone
(651) 439-4840
NPI assigned
Nov 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 21704 MN Primary

Addresses

Primary practice location

1875 Northwestern Ave S
Stillwater, MN 55082-7534

Mailing address

1875 Northwestern Ave S
Stillwater, MN 55082-7534
Phone (651) 439-4840

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
I20161128002058 MN Practitioner - Clinical Social Worker 5294014767 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Familymeans CurrentSince Aug 25, 2022 Accepting new patients
Canvas Health, Inc. CurrentSince Oct 22, 2016 Accepting new patients

Locations

7066 Stillwater Blvd N
Saint Paul, MN 55128

1875 Northwestern Ave S
Stillwater, MN 55082
Phone (651) 439-4840

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1306398599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 NORTHWESTERN AVE S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827534",
            "telephone_number": "651-439-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 NORTHWESTERN AVE S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550827534",
            "telephone_number": "651-439-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINCE",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.