Individual provider Active NPI

Taylor Ann Erola, LICSW

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1457076028
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29416 Issued in MN
Practice address
615 Pecan Ave
Duluth, MN 55811-2749
Phone
(218) 786-8364
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 29416 MN Primary

Addresses

Primary practice location

615 Pecan Ave
Duluth, MN 55811-2749

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • 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
I20221213002621 MN Practitioner - Clinical Social Worker 5496124430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightwater Health Dba Human Development Center CurrentSince Apr 26, 2024 Accepting new patients
Brightwater Health Dba Human Development Center PastSince Apr 26, 2024 Accepting new patients
SMDC Medical Center PastSince Oct 30, 2022 Accepting new patients

Locations

40 11th St
Cloquet, MN 55720
Phone (218) 879-4559

1401 E 1st St
Duluth, MN 55805
Phone (218) 728-4491

120 W 2nd St
Duluth, MN 55802
Phone (218) 728-4491

629 1st Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

Organizations & group practices 3

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": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1457076028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PECAN AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558112749",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EROLA",
        "first_name": "TAYLOR",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.