Jason A Brandt, MSW-LICSW
Individual provider Active NPI Clinical Social Worker · Hermantown, MN
NPI 1407889256 · NPPES record last updated Feb 21, 2008
Key facts
- NPI
- 1407889256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 16370 (MN)
- Practice address
- 5075 Miller Trunk Hwy
Hermantown, MN 55811-1442 - Phone
- (218) 729-6745
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16370 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic and Behavioral Health Services | Clinical | Past | Accepting new patients |
| Brightwater Health Dba Human Development Center | Past |
Accepting new patients | |
| The Duluth Clinic, LTD. | Past | Accepting new patients | |
| Brightwater Health Dba Human Development Center | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16370 | MN | Yes |
Addresses
Primary practice location
5075 Miller Trunk Hwy
Hermantown, MN 55811-1442
Mailing address
5075 Miller Trunk Hwy
Hermantown, MN 55811-1442
Phone (218) 729-6745
Other providers in Hermantown, MN
- April Dawn Bissonette
- Joannah Bluntach
- Skylar Mae Boe
- Jenna Bottila
- Paige Katherine Boyer
- April Lyn Brannan
- Tori A Brantal
- Aurora Marais Breidenbach
- Demi Rae Brewer
- Rachelle Elaine Brinkman
All providers in Hermantown, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.