Active NPI
Andreen Steven Midthune, LICSW
- Clinical Social Worker
- Winona, MN
National Provider Identifier
1538342746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1140
- Practice address
- 428 W Broadway St
Winona, MN 55987-5216 - Phone
- (507) 454-7711
- Fax
- (507) 452-0325
- NPI assigned
- Dec 11, 2007
- Sex
- Male
- 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 | 1140 | MN | Primary |
Addresses
Primary practice location
428 W Broadway St
Winona, MN 55987-5216
Mailing address
428 W Broadway St
Winona, MN 55987-5216
Phone (507) 454-7711
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1140 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230854400000",
"number": "1538342746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "428 W BROADWAY ST",
"city": "WINONA",
"state": "MN",
"postal_code": "559875216",
"telephone_number": "507-454-7711",
"fax_number": "507-452-0325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 W BROADWAY ST",
"city": "WINONA",
"state": "MN",
"postal_code": "559875216",
"telephone_number": "507-454-7711",
"fax_number": "507-452-0325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDTHUNE",
"first_name": "ANDREEN",
"middle_name": "STEVEN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-11",
"last_updated": "2009-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "1140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.