Individual provider Active NPI

Brian Jessy Oduguwa, MSW, LICSW

  • Clinical Social Worker
  • Plymouth, MN
National Provider Identifier
1497358733
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22350 Issued in MN
Practice address
Address: 10000 Hwy 55
Suite 200
Plymouth, MN 55441
Phone
(612) 217-2019
NPI assigned
Nov 19, 2020
Last updated
Apr 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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 22350 MN Primary

Addresses

Primary practice location

Address: 10000 Hwy 55
Suite 200
Plymouth, MN 55441

Mailing address

1904 14TH St S
Saint Cloud, MN 56301-4813
Phone (763) 772-7737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey Insights Counseling LLC Clinical Current Accepting new patients
Peak Behavioral Health, LLC Clinical PastSince Nov 1, 2020 Accepting new patients

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, 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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1497358733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 14TH ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014813",
            "telephone_number": "763-772-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ADDRESS: 10000 HWY 55",
            "address_2": "SUITE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "612-217-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUGUWA",
        "first_name": "BRIAN",
        "middle_name": "JESSY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-19",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.