Douglas Alan Drew, MA, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7998 Issued in MN

Practice address

10190 Baltimore St NE
Suite 110
Blaine, MN 55449-5056

Phone

(763) 755-7612

Fax

(763) 775-2048

NPI assigned

Oct 31, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Family Based Therapy Associates

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1194762005
  NPD (past)
• Family Based Therapy Associates

  • Community/Behavioral Health Agency
  • Chisago City, MN
  • NPI 1891100293
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376534214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14701 HARPERS ST NE",
            "city": "HAM LAKE",
            "state": "MN",
            "postal_code": "553046428",
            "telephone_number": "763-413-2829",
            "fax_number": "763-413-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10190 BALTIMORE ST NE",
            "address_2": "SUITE 110",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495056",
            "telephone_number": "763-755-7612",
            "fax_number": "763-775-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "credential": "MA, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "7998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141257400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Rose Donnelly, PHD
• Laura Elizabeth Dougherty
• Douglas T Jonak DDS PA
• Dr. Andrew Brown Chiropracitc PC
• Dr. Rebecca R. Jackson LLC (Build and Balance Chiropractic Center)
• Gina Rose Dronen, LPCC
• Stephanie Dube
• Nishant Dwivedi, MD
• Ear Institutes, LLC (MN Ear & Sinus Center)
• Danielle Kay Earp, PA-C

• Clinical Social Worker in Blaine, MN
• Providers in Blaine, 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 Jul 8, 2007; 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.