Justin L Schmiesing, MSW, LICSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28192 Issued in MN

Practice address

40 11TH St
Cloquet, MN 55720-1817

Phone

(218) 879-4559

Fax

(218) 879-0282

NPI assigned

Nov 17, 2016

Last updated

Mar 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eden Therapy Center, LLCGroup PAC ID 7810381985, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Eden Therapy Center, LLC

  dba Eden Therapy Center

  • Mental Health Counselor
  • Eden Prairie, MN
  • NPI 1275037277
  Medicare reassignment Care Compare group NPD
• Brightwater Health Dba Human Development Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1194790733

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Brightwater Health Dba Human Development Center

  • Community/Behavioral Health Agency
  • Cloquet, MN
  • NPI 1114048527
  NPD (past)

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1457893711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 11TH ST",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201817",
            "telephone_number": "218-879-4559",
            "fax_number": "218-879-0282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161300",
            "country_code": "US",
            "telephone_number": "218-834-5520",
            "fax_number": "218-834-4264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558022017",
            "country_code": "US",
            "telephone_number": "218-728-3931",
            "fax_number": "218-302-8698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 E 4th St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052147",
            "country_code": "US",
            "telephone_number": "218-624-5683",
            "fax_number": "218-624-5736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052407",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMIESING",
        "first_name": "JUSTIN",
        "middle_name": "L",
        "credential": "MSW, LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-17",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305320",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28192",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WI",
            "license": "17801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharlene May Santmyer, MSW, LICSW
• Lindsey Saukko
• Lucas Ryan Scherer, MSW, LICSW
• Sheila Scheuer, PHARM D
• Jamie Rae Schlagel
• John Elmer Schmitt Jr., MD
• Elenore C Schoenfeld, LICSW
• Laura Lynn Schuster
• Janette Mary Setterquist, RN
• Terry Michael Setterquist, DC

• Clinical Social Worker in Cloquet, MN
• Providers in Cloquet, 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 Mar 30, 2022; 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.