Active NPI
Carla Sandahl Mortensen, MSW LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1497783658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4547
- Practice address
- 3548 Bryant Ave S
The Mental Health Collective
Minneapolis, MN 55408-4119 - Phone
- (612) 822-8227
- Fax
- (612) 825-4204
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4547 | MN | Primary |
Addresses
Primary practice location
3548 Bryant Ave S
The Mental Health Collective
Minneapolis, MN 55408-4119
Mailing address
3548 Bryant Ave S
The Mental Health Collective
Minneapolis, MN 55408-4119
Phone (612) 822-8227
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4547 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John a. Loraas, PH.D., P.a. | Past | Accepting new patients | |
| The Mental Health Collective | Past | Accepting new patients | |
| Watercourse Counseling Center | Past | Accepting new patients | |
| Dakota Valley Psychologists | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Apple Valley, MN
- NPI 1952463382
-
- Clinical Psychologist
- Apple Valley, MN
- NPI 1730388562
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Minneapolis, MN
- NPI 1932126794
-
- Community/Behavioral Health Agency
- Minneapolis, MN
- NPI 1770847246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497783658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3548 BRYANT AVE S",
"address_2": "THE MENTAL HEALTH COLLECTIVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554084119",
"telephone_number": "612-822-8227",
"fax_number": "612-825-4204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3548 BRYANT AVE S",
"address_2": "THE MENTAL HEALTH COLLECTIVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554084119",
"telephone_number": "612-822-8227",
"fax_number": "612-825-4204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "CARLA",
"middle_name": "SANDAHL",
"credential": "MSW LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "4547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.