Richard Edwin Close, DMIN, MA,LICSW, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

07734 Issued in MN

Practice address

3450 Oleary LN
Eagan, MN 55123-2340

Phone

(651) 454-0114

Fax

(651) 454-3492

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Natalis Counseling and Psychology Solutions, P.a.Group PAC ID 5193756104, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Natalis Counseling and Psychology Solutions, P.a.

  • Psychologist
  • Saint Paul, MN
  • NPI 1447369673
  Medicare reassignment Care Compare group NPD
• Eagan Counseling Clinic

  • Clinical Psychologist
  • Eagan, MN
  • NPI 1144311184
  Medicare reassignment

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544832000000",
    "number": "1457379026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-454-0114",
            "fax_number": "651-454-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-454-0114",
            "fax_number": "651-454-3492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7582 Currell Blvd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551252471",
            "country_code": "US",
            "telephone_number": "651-739-7539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOSE",
        "first_name": "RICHARD",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "DMIN, MA,LICSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "0067",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "07734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636357100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette Irene Clarke
• Jaemika Monique Clarke
• Stefanie Clarkin, OTR/L
• Cliff Road Chiropractic
• Zeb Clift
• Trevor Martin Cobb, APRN, FNP-C
• Kristine Mary Cody
• Silas Cooper Coghill
• Carole P Cohen, OTR/L
• Nancy Nutting Cohen, LAMFT

• Clinical Social Worker in Eagan, MN
• Providers in Eagan, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.