Individual provider Active NPI

Susan L Littrell

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1508908385
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00943 Issued in MN
Practice address
525 Portland Ave
Minneapolis, MN 55415-1533
Phone
(612) 596-1223
Fax
(612) 677-6248
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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 00943 MN Primary

Addresses

Primary practice location

525 Portland Ave
Minneapolis, MN 55415-1533

Mailing address

6646 Falstaff Rd
Woodbury, MN 55125-3803

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

State licenses

LicenseStateTypeSpecialty
00943MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1508908385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6646 FALSTAFF RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-596-1223",
            "fax_number": "612-677-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTRELL",
        "first_name": "SUSAN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "00943",
            "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 Jun 26, 2013; 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.