Individual provider Active NPI

Elizabeth Lauren Anderson, LICSW

  • Clinical Social Worker
  • Edina, MN
National Provider Identifier
1487998977
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20233 Issued in MN
Practice address
3601 Minnesota Dr Ste 575
Edina, MN 55435-5213
Phone
(612) 223-8898
NPI assigned
Nov 21, 2012
Last updated
Apr 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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 20233 MN Primary

Addresses

Primary practice location

3601 Minnesota Dr Ste 575
Edina, MN 55435-5213

Mailing address

7601 Wayzata Blvd
Minneapolis, MN 55426-1623
Phone (612) 223-8898

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
I20140709001455 MN Practitioner - Clinical Social Worker 3779708664 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20233MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Psych Group, LLC CurrentSince Mar 25, 2022 Accepting new patients
Bushman Psychological Services LLC CurrentSince Jul 17, 2015 Accepting new patients
Supportive Journeys Psychotherapy, LLC Clinical Past Accepting new patients
Many Sparrows LLC Past Accepting new patients
Bohn Counseling Associates, Inc, Past Accepting new patients

Locations

14551 Judicial Rd
Ste 100
Burnsville, MN 55306
Phone (952) 898-5020

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

Organizations & group practices 5

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": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1487998977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261623",
            "telephone_number": "612-223-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 MINNESOTA DR STE 575",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355213",
            "telephone_number": "612-223-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELIZABETH",
        "middle_name": "LAUREN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.