Active NPI
Susan Marie Opperman, LICSW
- Clinical Social Worker
- Bloomington, MN
National Provider Identifier
1447722772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 22833
- Practice address
- 5414 W Old Shakopee Cir
Bloomington, MN 55437-2766 - Phone
- (952) 888-5611
- Fax
- (952) 888-3741
- NPI assigned
- Dec 27, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 22833 | MN | Primary |
Addresses
Primary practice location
5414 W Old Shakopee Cir
Bloomington, MN 55437-2766
Mailing address
5414 W Old Shakopee Cir
Bloomington, MN 55437-2766
Phone (952) 888-5611
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22833 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Metro Human Services Dba Radias Health | Past | Accepting new patients | |
| TMS Treatment Center Inc | Past | Accepting new patients |
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.
-
- Mental Illness Community Based Residential Treatment Facility
- Bloomington, MN
- NPI 1790412641
-
- Mental Illness Community Based Residential Treatment Facility
- Bloomington, MN
- NPI 1821181421
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545868800000",
"number": "1447722772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5414 W OLD SHAKOPEE CIR",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554372766",
"telephone_number": "952-888-5611",
"fax_number": "952-888-3741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5414 W OLD SHAKOPEE CIR",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554372766",
"telephone_number": "952-888-5611",
"fax_number": "952-888-3741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPPERMAN",
"first_name": "SUSAN",
"middle_name": "MARIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-27",
"last_updated": "2018-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "22833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.