Individual provider Active NPI

Heather Marie Wakefield

  • Clinical Social Worker
  • Cambridge, MN
National Provider Identifier
1538682182
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22472 Issued in MN
Practice address
237 2ND Ave SW Ste 117
Cambridge, MN 55008-1500
Phone
(763) 689-9407
NPI assigned
Jul 25, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 22472 MN Primary

Addresses

Primary practice location

237 2ND Ave SW Ste 117
Cambridge, MN 55008-1500

Mailing address

199 Coon Rapids Blvd NW Ste 306
Coon Rapids, MN 55433-5861

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
I20170911000096 MN Practitioner - Clinical Social Worker 3375816531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Based Therapy AssociatesGroup PAC ID 2264432681, 12 clinicians

Practice addresses (Care Compare)

199 Coon Rapids Blvd NW
Suite 306
Coon Rapids, MN 55433-5861
Phone (763) 780-1520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22472MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Based Therapy Associates CurrentSince Aug 12, 2017 Accepting new patients
Family Based Therapy Associates Past Accepting new patients

Locations

237 2nd Ave SW
Cambridge, MN 55008
Phone (651) 245-5217

237 2nd Ave SW
Ste 117
Cambridge, MN 55008
Phone (763) 200-3411

199 Coon Rapids Blvd NW
Ste 306
Minneapolis, MN 55433
Phone (763) 780-1520

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538682182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW STE 306",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 2ND AVE SW STE 117",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081500",
            "telephone_number": "763-689-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MN

Sources for this page

Verify at the official NPI Registry.