Bobi Lyn Spaeth

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21711 Issued in MN

Practice address

1027 Washington Avenue
Detroit Lakes, MN 56501-3409

Phone

(218) 847-5611

NPI assigned

Aug 3, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• White Earth Band of Ojibwe - Indian Child Welfare

  • Professional Counselor
  • Ogema, MN
  • NPI 1457639551

  Clinical

  NPD (past)

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1548714876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 1ST AVE",
            "city": "WAUBUN",
            "state": "MN",
            "postal_code": "565894112",
            "telephone_number": "218-473-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 WASHINGTON AVENUE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013409",
            "telephone_number": "218-847-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Feather St",
            "address_purpose": "LOCATION",
            "city": "Ogema",
            "state": "MN",
            "postal_code": "565696902",
            "country_code": "US",
            "telephone_number": "218-983-3011 x6103",
            "fax_number": "218-983-3002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAETH",
        "first_name": "BOBI",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin C Smith, MD
• Branden Smith
• Stacey A Smith, MD
• Sherri L Softing, RD, LD
• Kelly J Soyring, OTR
• Spectrum Health
• Dawn Spitzer
• St Mary'S Innovis Health
• St Mary'S Regional Health Center
• St Mary'S Regional Health Center

• Clinical Social Worker in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.