Individual provider Active NPI

Deann Lea Reese, LICSW

  • Clinical Social Worker
  • Alexandria, MN
National Provider Identifier
1457363632
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11974 Issued in MN
Practice address
316 Broadway St Ste 7
Alexandria, MN 56308-1981
Phone
(320) 634-6434
NPI assigned
Aug 13, 2006
Last updated
Apr 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 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 11974 MN Primary

Addresses

Primary practice location

316 Broadway St Ste 7
Alexandria, MN 56308-1981

Mailing address

612 Adobe Cir
Marshall, MN 56258-2402

Other practice location 1

1212 E College Dr
Marshall, MN 56258-2010
Phone (507) 532-3236

Other identifiers 7

IdentifierTypeStateIssuer
10005OtherMNAVERA HEALTH PLAN
557T9REOtherMNBLUE CROSS BLUE SHIELD
42274OtherMNSIOUX VALLEY HEALTH
HP49874OtherMNHEALTH PARTNERS
1043050OtherMNPREFERRED ONE
113291OtherMNUCARE
534148500MedicaidMN

Other names 1

  • Miss Deann Lea Houtsma Former name

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
I20050310000858 MN Practitioner - Clinical Social Worker 3678527710 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy Solutions LLCGroup PAC ID 9335533850, 2 clinicians

Practice addresses (Care Compare)

720 Broadway St
Suite 200
Alexandria, MN 56308-1812
Phone (320) 634-6434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Psych Group, LLC CurrentSince May 1, 2021 Accepting new patients
Integrated Therapy Solutions LLC Clinical CurrentSince Sep 14, 2021 Accepting new patients
Western Mental Health Center, Inc. CurrentSince Aug 14, 2017 Accepting new patients

Locations

316 Broadway St
Ste 7
Alexandria, MN 56308
Phone (320) 634-6434

720 Broadway St
Ste 200
Alexandria, MN 56308

1212 E College Dr
Marshall, MN 56258
Phone (507) 532-3236

9655 Schmidt Lake Rd
Ste 150
Plymouth, MN 55442
Phone (763) 559-1640

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/wmhcinc/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1457363632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 ADOBE CIR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 BROADWAY ST STE 7",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081981",
            "telephone_number": "320-634-6434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1212 E College Dr",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "MN",
            "postal_code": "562582010",
            "country_code": "US",
            "telephone_number": "507-532-3236",
            "fax_number": "507-532-0240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REESE",
        "first_name": "DEANN",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "11974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVERA HEALTH PLAN",
            "identifier": "10005",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "557T9RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH",
            "identifier": "42274",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP49874",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1043050",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "113291",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "534148500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANN",
            "last_name": "HOUTSMA",
            "middle_name": "LEA",
            "prefix": "MISS",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, MN

Sources for this page

Verify at the official NPI Registry.