Individual provider Active NPI

Rosie Shayna Math

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1518558071
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26819 Issued in MN
Practice address
1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone
(612) 871-1454
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 26819 MN Primary

Addresses

Primary practice location

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Mailing address

1100 Glenwood Ave
Minneapolis, MN 55405-1430
Phone (612) 871-1454

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
I20230914001435 MN Practitioner - Clinical Social Worker 6709240336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince Aug 2, 2023 Accepting new patients
Washburn Center for Children PastSince Jan 31, 2021 Accepting new patients

Locations

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1518558071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051430",
            "telephone_number": "612-871-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATH",
        "first_name": "ROSIE",
        "middle_name": "SHAYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.