Elizabeth Falk, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25702 Issued in MN

Practice address

809 Douglas Ave Apt 302
Minneapolis, MN 55403-3118

Phone

(612) 227-4629

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Vantage Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park Heights, MN
  • NPI 1538990288
  Medicare reassignment NPD
• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Collaborative Psychiatric Services LLC

  • Psychiatry Physician
  • Oak Park Heights, MN
  • NPI 1699525857
  NPD (past)

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1356072946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SUPERIOR DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 DOUGLAS AVE APT 302",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033118",
            "telephone_number": "612-227-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALK",
        "first_name": "ELIZABETH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.greatlakespsychservices.com",
            "affiliation": "N",
            "address_1": "3101 Superior Dr NW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559011993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Khadija Abdiaziz Fakrudin
• Kari Lynn Falaas
• Mary-Anne Falade
• Steffani N Falardeaux
• Caitlin Falconer, MS, CCC-SLP
• Leah Marie Falk, MA, LADC, MS, LPCC
• Jolaina L Falkenstein, LMFT
• Joseph Falkner, SLP
• Alan Francis Falkowski, PA-C
• Eliza Fallick

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Jun 23, 2022; 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.