Active NPI
Tanice Marie Welter
- Clinical Social Worker
- Saint Paul, MN
National Provider Identifier
1326650631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 27347
- Practice address
- 670 Cleveland Ave S
Saint Paul, MN 55116-1218 - Phone
- (763) 913-8261
- Fax
- (763) 210-5221
- NPI assigned
- Aug 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27347 | MN | Primary |
Addresses
Primary practice location
670 Cleveland Ave S
Saint Paul, MN 55116-1218
Mailing address
1454 Breda Ave
Saint Paul, MN 55108-2605
Phone (850) 382-0692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 11, 2023 through Dec 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27347 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1326650631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1454 BREDA AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551082605",
"telephone_number": "850-382-0692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 CLEVELAND AVE S",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551161218",
"telephone_number": "763-913-8261",
"fax_number": "763-210-5221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELTER",
"first_name": "TANICE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-18",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "27347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.