Individual provider Active NPI

Roxanne Threlfall

  • Social Worker
  • Minneapolis, MN
National Provider Identifier
1356032650
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3550 Knox Ave N
Minneapolis, MN 55412-2452
Phone
(952) 303-1859
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3550 Knox Ave N
Minneapolis, MN 55412-2452

Mailing address

14000 Northdale Blvd Unit 1
Rogers, MN 55374-4662

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
I20240328000512 MN Practitioner - Clinical Social Worker 2769829589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanda Counseling and Psychological ServicesGroup PAC ID 6608192083, 20 clinicians

Practice addresses (Care Compare)

14000 Northdale Blvd
Suite I
Rogers, MN 55374-4663
Phone (763) 575-8086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vanda Counseling and Psychological Services CurrentSince Jan 8, 2024 Accepting new patients

Locations

4969 Olson Memorial Hwy
Minneapolis, MN 55422
Phone (763) 575-8086

14000 Northdale Blvd
Ste I
Rogers, MN 55374
Phone (763) 575-8086

Organizations & group practices 1

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1356032650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 NORTHDALE BLVD UNIT 1",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 KNOX AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122452",
            "telephone_number": "952-303-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRELFALL",
        "first_name": "ROXANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.