Individual provider Active NPI

Bridget Leonard

  • Clinical Social Worker
  • Fergus Falls, MN
National Provider Identifier
1316368616
Registry record updated Jan 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18865 Issued in MN
Practice address
612 S Union Ave
Fergus Falls, MN 56537-2711
Phone
(651) 587-3884
NPI assigned
Jan 4, 2014
Last updated
Jan 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2014

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 18865 MN Primary

Addresses

Primary practice location

612 S Union Ave
Fergus Falls, MN 56537-2711

Mailing address

612 S Union Ave
Fergus Falls, MN 56537-2711
Phone (651) 587-3884

Other names 1

  • Bridget Brown Former name

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
I20140328000060 MN Practitioner - Clinical Social Worker 3678704061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life on Purpose Counseling and Neurofeedback IncGroup PAC ID 2466712997, 3 clinicians

Practice addresses (Care Compare)

312 County Rd D E
Little Canada, MN 55117-1275
Phone (651) 600-7876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life on Purpose Counseling & Neurofeedback Inc Clinical CurrentSince Oct 27, 2023 Accepting new patients

Locations

312 County Road D E
Saint Paul, MN 55117
Phone (651) 600-7876

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, 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": "1388793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388793600000",
    "number": "1316368616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S UNION AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372711",
            "telephone_number": "651-587-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S UNION AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372711",
            "telephone_number": "651-587-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "BRIDGET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-04",
        "last_updated": "2014-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "BROWN",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.