Andrea Nelson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8280-123 Issued in WI

Practice address

2222 E 5TH St
Superior, WI 54880-3709

Phone

(715) 392-1955

Fax

(715) 392-1935

NPI assigned

Mar 5, 2015

Last updated

Oct 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Andrea Renshaw Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Up North Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Silver Bay, MN
  • NPI 1154918951
  Medicare reassignment NPD
• Center for Alcohol and Drug Treatment, Inc.

  • Professional Counselor
  • Duluth, MN
  • NPI 1619196524
  Medicare reassignment
• Brightwater Health Dba Human Development Center

  dba Human Development Center

  • Community/Behavioral Health Agency
  • Superior, WI
  • NPI 1407021579
  NPD (past)

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1427441104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803709",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803709",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANDREA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21278",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8280-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "RENSHAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wendy Michelle Morris, LPC-IT
• Dawn Moulton, RPT
• Nbo Dental, LLC
• Neal B O'Shaughnessy DDS LTD
• Adele Alyse Negash, CCC/SLP
• Jon Gregorie Nelson, D.D.S
• Barbara M Nett
• Neve Inc (Avada Audiology & Hearing Care)
• Tammy Newberry
• Karen Wyse Niedermier, APRN, CNP

• Clinical Social Worker in Superior, WI
• Providers in Superior, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.