Individual provider Active NPI

Neil Allen Greco, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1497084339
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17557 Issued in MN
Practice address
965 Avon St N Apt 3
Saint Paul, MN 55103-1356
Phone
(612) 888-7809
NPI assigned
Dec 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Social Worker 104100000X
Clinical Social Worker 1041C0700X 17557 MN Primary

Addresses

Primary practice location

965 Avon St N Apt 3
Saint Paul, MN 55103-1356

Mailing address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone (612) 596-1223

Other identifiers 1

IdentifierTypeStateIssuer
17557OtherMNBOARD OF SW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • 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
I20170112000760 MN Practitioner - Clinical Social Worker 0446531131 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan & Associates, LLC Clinical CurrentSince Jul 1, 2019 Accepting new patients
Community Based Mental Health Consulting and Training Clinical CurrentSince Dec 15, 2024 Accepting new patients

Locations

2233 Hamline Ave N
Ste 435
Saint Paul, MN 55113
Phone (612) 444-9781

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1497084339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-596-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 AVON ST N APT 3",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551031356",
            "telephone_number": "612-888-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECO",
        "first_name": "NEIL",
        "middle_name": "ALLEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-23",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SW",
            "identifier": "17557",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.