Individual provider Active NPI

Laurie Lynne Nelson, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1386785855
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22334 Issued in MN
Practice address
1200 Marquette Ave
Minneapolis, MN 55403-2419
Phone
(952) 939-0396
NPI assigned
Feb 9, 2007
Last updated
Apr 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 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 22334 MN Primary

Addresses

Primary practice location

1200 Marquette Ave
Minneapolis, MN 55403-2419

Mailing address

10505 Wayzata Blvd
Suite 200
Minnetonka, MN 55305-1502
Phone (763) 464-7460

Other practice location 1

10505 Wayzata Blvd
Suite 200
Minnetonka, MN 55305-1502
Phone (763) 464-7460

Other practice location 2

3395 Plymouth Rd
Minnetonka, MN 55305-3765
Phone (952) 939-0396

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
I20190403000540 MN Practitioner - Clinical Social Worker 7517016983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lorenz Clinic LLCGroup PAC ID 7810282845, 24 clinicians

Practice addresses (Care Compare)

1435 White Oak Dr
Suite 200
Chaska, MN 55318-2567
Phone (952) 443-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lorenz Clinic, LLC CurrentSince Mar 18, 2019 Accepting new patients
Vera French Community Mental Health PastSince Oct 1, 2007 Accepting new patients
Vera French Community Mental Health PastSince Dec 10, 2023 Accepting new patients

Locations

1435 White Oak Dr
Ste 200
Chaska, MN 55318
Phone (651) 374-1470

1772 Stieger Lake Ln
Ste 220
Victoria, MN 55386
Phone (952) 433-4600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1386785855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10505 WAYZATA BLVD",
            "address_2": "SUITE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051502",
            "telephone_number": "763-464-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MARQUETTE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032419",
            "telephone_number": "952-939-0396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10505 Wayzata Blvd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553051502",
            "country_code": "US",
            "telephone_number": "763-464-7460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3395 Plymouth Rd",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553053765",
            "country_code": "US",
            "telephone_number": "952-939-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LAURIE",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.