Active NPI
Sandra Kay Simonson, MS, LICSW
- Clinical Social Worker
- Saint Paul, MN
National Provider Identifier
1447357488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 05961
- Practice address
- 984 Ashland Ave
Saint Paul, MN 55104-7001 - Phone
- (952) 997-7961
- Fax
- (952) 997-7961
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 05961 | MN | Primary |
Addresses
Primary practice location
984 Ashland Ave
Saint Paul, MN 55104-7001
Mailing address
PO Box 240541
Apple Valley, MN 55124-0541
Phone (952) 997-7961
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023327700 | Medicaid | MN | |
| 2177398 | Other | CIGNA | |
| 110385 | Other | HEALTHPARTNERS | |
| 530T6SI | Other | BLUE CROSS BLUE SHIELD | |
| 62-71799 | Other | UNITED BEHAVIORAL HEALTH | |
| A60887208767 | Other | PREFERREDONE |
Other names 1
- Ms. Sandra Kay Zellmer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05961 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424908800000",
"number": "1447357488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 240541",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551240541",
"telephone_number": "952-997-7961",
"fax_number": "952-997-7961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "984 ASHLAND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551047001",
"telephone_number": "952-997-7961",
"fax_number": "952-997-7961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONSON",
"first_name": "SANDRA",
"middle_name": "KAY",
"name_prefix": "Ms.",
"credential": "MS, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2015-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "05961",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023327700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2177398",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "110385",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "530T6SI",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "62-71799",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "A60887208767",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SANDRA",
"last_name": "ZELLMER",
"middle_name": "KAY",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.