Individual provider Active NPI

Anna Lenore Dralle, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1396234480
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24751 Issued in MN
Practice address
1309 Girard Ave N
Minneapolis, MN 55411-3128
Phone
(612) 230-0730
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 24751 MN Primary

Addresses

Primary practice location

1309 Girard Ave N
Minneapolis, MN 55411-3128

Mailing address

3042 Garfield St NE
Minneapolis, MN 55418-2222
Phone (651) 497-1223

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
I20180619000378 MN Practitioner - Clinical Social Worker 0446505283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Recovery IncGroup PAC ID 3779633912, 22 clinicians

Practice addresses (Care Compare)

2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1052
Phone (651) 645-3115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Recovery Inc Clinical CurrentSince Dec 2, 2019 Accepting new patients
Psychiatric Recovery PA PastSince Dec 2, 2019 Accepting new patients

Locations

2550 University Ave W
Ste 229N
Saint Paul, MN 55114
Phone (651) 645-3115

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1396234480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 GARFIELD ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554182222",
            "telephone_number": "651-497-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 GIRARD AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554113128",
            "telephone_number": "612-230-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRALLE",
        "first_name": "ANNA",
        "middle_name": "LENORE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.