Individual provider Active NPI

Coleen R May, MSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1346280435
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2753 Issued in ND
Practice address
2624 9TH Ave S
Fargo, ND 58103-2350
Phone
(701) 298-4500
Fax
(701) 298-4400
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 2753 ND Primary
Clinical Social Worker 1041C0700X 12248 MN

Addresses

Primary practice location

2624 9TH Ave S
Fargo, ND 58103-2350

Mailing address

338 15TH St S
Moorhead, MN 56560-3036

Other identifiers 6

IdentifierTypeStateIssuer
16R44MAOtherFMBLLUE SHIELD OF MINNESOTA
17786OtherMNNORTH DAKOTA BLUE SHIELD
108218300MedicaidMN
1016218OtherMNPREFERREDONE
HP27801OtherMNHEALTHPARTNERS
111699OtherMNUCARE MINNESOTA

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
I20101013000467 MN Practitioner - Clinical Social Worker 3274725932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Mental Health Center IncGroup PAC ID 1759291891, 39 clinicians

Practice addresses (Care Compare)

1010 S 32ND Ave
Moorhead, MN 56560-5001
Phone (218) 233-7524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2753NDMDPhysical Therapist
12248MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Mental Health Center Case Manager/Care Coordinator PastSince Aug 2, 2021 Accepting new patients

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1346280435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 15TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032350",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAY",
        "first_name": "COLEEN",
        "middle_name": "R",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "2753",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLLUE SHIELD OF MINNESOTA",
            "identifier": "16R44MA",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA BLUE SHIELD",
            "identifier": "17786",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108218300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "1016218",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP27801",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MINNESOTA",
            "identifier": "111699",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.