Individual provider Active NPI

Ann Clara Fasching

  • Clinical Social Worker
  • Eagan, MN
National Provider Identifier
1376044149
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1072 Issued in MN
Practice address
3450 Oleary LN
Eagan, MN 55123-2340
Phone
(651) 454-0114
NPI assigned
Feb 26, 2018
Last updated
Feb 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1072 MN Primary

Addresses

Primary practice location

3450 Oleary LN
Eagan, MN 55123-2340

Mailing address

88 River Woods LN
Burnsville, MN 55337-3317
Phone (952) 894-8848

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
I20180620003264 MN Practitioner - Clinical Social Worker 9133474810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Minnesota Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagan Counseling ClinicGroup PAC ID 2860304045, 62 clinicians

Practice addresses (Care Compare)

3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1376044149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 RIVER WOODS LN",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373317",
            "telephone_number": "952-894-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-454-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASCHING",
        "first_name": "ANN",
        "middle_name": "CLARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.