Autumn Marie Jarvis, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31486 Issued in MN

Practice address

502 E 2ND St
Duluth, MN 55805-1913

Phone

(218) 786-8376

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Autumn Marie Erdmann Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: autumn.jarvis.1@30520.direct.athenahealth.com

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  MN

  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment NPD
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209

  WI

  Medicare reassignment NPD
• Bellin Psychiatric Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1952554800
  Medicare reassignment NPD
• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Hermantown, MN
  • NPI 1003478892
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• Bellin Psychiatric Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1598728776

  Clinical

  NPD
• Power for Change, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1124322284
  NPD (past)

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1336725720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10408 US HIGHWAY 151",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542209775",
            "telephone_number": "715-410-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-786-8376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 N Oakland Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543032831",
            "country_code": "US",
            "telephone_number": "920-770-4088",
            "fax_number": "651-705-0026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 E Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537033688",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "729 Washington Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554012942",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2581 University Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "54311",
            "country_code": "US",
            "telephone_number": "920-431-2303 x72752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "AUTUMN",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "090420149",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117151",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31486",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9823",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904020149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1041C0700X",
            "identifier": "6801117151",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "9823-123",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.powerforchangellc.com",
            "affiliation": "Y",
            "endpointDescription": "Website",
            "affiliationName": "Power for Change, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "123 N Oakland Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543032831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "ERDMANN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• James T Jarosz, DDS
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• Jeff Hady Inc.
• Jayme R Jefferson
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• Clinical Social Worker in Duluth, MN
• Providers in Duluth, 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 May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.