Angela Kay Djoumbaye, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26450 Issued in MN

Practice address

4801 Veterans Dr
Saint Cloud, MN 56303-2015

Phone

(320) 252-1670

NPI assigned

Jan 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Affinity Psychological Services PCGroup PAC ID 0749528552, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Affinity Psychological Services, P.C.

  • Mental Health Counselor
  • Edina, MN
  • NPI 1245610856
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1548777402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015",
            "telephone_number": "320-252-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOUMBAYE",
        "first_name": "ANGELA",
        "middle_name": "KAY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "26450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26450",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "26450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nimo Mohamed Diriye, REGISTERED NURSE
• Kelsi Dirkes
• Kerri Dirkes
• Distinct Transportation Services
• Andrea Dixon, PHARMD
• Dma Express Inc
• Alexa Dobberstein, RN
• Alyssa Jane Dobmeier, MSW, LGSW, LADC
• Jamie Marie Dockendorf, PA-C
• Nicole Ann Dockendorf, LPN

• Clinical Social Worker in Saint Cloud, MN
• Providers in Saint Cloud, 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 Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.