Individual provider Active NPI

Saprina Ann Matheny, LICSW

  • Clinical Social Worker
  • Cloquet, MN
National Provider Identifier
1407978596
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16047 Issued in MN
Practice address
1102 Cloquet Ave
Cloquet, MN 55720
Phone
(218) 302-4901
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 16047 MN Primary

Addresses

Primary practice location

1102 Cloquet Ave
Cloquet, MN 55720

Mailing address

1102 Cloquet Ave
Cloquet, MN 55720-1620
Phone (218) 302-4901

Other practice location 1

4328 E Superior St
Duluth, MN 55804-2177
Phone (218) 302-4901

Other identifiers 1

IdentifierTypeStateIssuer
861464400MedicaidMN

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
I20050818001046 MN Practitioner - Clinical Social Worker 8729018700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4328 E Superior St
Duluth, MN 55804-2177
Phone (218) 302-4901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Matheny Therapy & Consulting LLC Clinical CurrentSince Dec 1, 2016 Accepting new patients
Matheny Therapy & Consulting, LLC Clinical Current Accepting new patients

Locations

1102 Cloquet Ave
Cloquet, MN 55720
Phone (218) 499-7000

4328 E Superior St
Duluth, MN 55804
Phone (218) 302-4901

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1407978596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201620",
            "telephone_number": "218-302-4901",
            "fax_number": "218-728-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "55720",
            "telephone_number": "218-302-4901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4328 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558042177",
            "country_code": "US",
            "telephone_number": "218-302-4901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "SAPRINA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "861464400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.