Erin Zeller, LICSW

Individual provider Active NPI Clinical Social Worker · Jordan, MN

NPI 1457726895 · NPPES record last updated Dec 10, 2015

Key facts

NPI
1457726895
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
21797 (MN)
Practice address
603 Hope Ave
Jordan, MN 55352-1860
Phone
(952) 492-3624
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160128000764 MN Practitioner - Clinical Social Worker 9234382904 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar House Inc. Current
since Dec 5, 2015
Accepting new patients

Locations

329 Faribault Rd
Faribault, MN 55021
Phone (507) 334-1030

603 Hope Ave
Jordan, MN 55352
Phone (952) 492-3624

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21797 MN Yes

Addresses

Primary practice location

603 Hope Ave
Jordan, MN 55352-1860

Mailing address

329 Faribault Rd
Faribault, MN 55021-5780
Phone (507) 334-1983

Other providers in Jordan, MN

All providers in Jordan, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.