Individual provider Active NPI

Jennifer Marie Webb

  • Clinical Social Worker
  • Willmar, MN
National Provider Identifier
1417585084
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25481 Issued in MN
Practice address
1809 19TH Ave SW
Willmar, MN 56201-4946
Phone
(320) 741-7000
Fax
(320) 441-7005
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 25481 MN Primary

Addresses

Primary practice location

1809 19TH Ave SW
Willmar, MN 56201-4946

Mailing address

1809 19TH Ave SW
Willmar, MN 56201-4946
Phone (320) 441-7000

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
I20210121003094 MN Practitioner - Clinical Social Worker 5698189207 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

911 18TH St N
Saint Cloud, MN 56303-1203
Phone (320) 650-1660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Knutson Counseling & Seminars, Inc. CurrentSince Dec 17, 2020 Accepting new patients
Central Minnesota Mental Health Center CurrentSince Sep 1, 2021 Accepting new patients
Catholic Charities of the Diocese of St. Cloud CurrentSince Aug 6, 2024 Accepting new patients
Catholic Charities of the Diocese of St. Cloud CurrentSince Aug 6, 2024 Accepting new patients
Central Minnesota Mental Health Center CurrentSince Sep 1, 2021 Accepting new patients

Locations

308 12th Ave S
Buffalo, MN 55313
Phone (763) 682-4400

911 18th St N
Saint Cloud, MN 56303
Phone (320) 650-1550

1321 13th St N
Saint Cloud, MN 56303
Phone (320) 252-5010

411 3rd St N
Waite Park, MN 56387
Phone (320) 202-2037

328 5th St SW
Ste 5
Willmar, MN 56201

1809 19th Ave SW
Willmar, MN 56201
Phone (320) 441-7000

Organizations & group practices 5

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1417585084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946",
            "telephone_number": "320-441-7000",
            "fax_number": "320-441-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014946",
            "telephone_number": "320-741-7000",
            "fax_number": "320-441-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.