Individual provider Active NPI

Coleen Maclean Groen, MSW, LCSW

  • Clinical Social Worker
  • Lake Elmo, MN
National Provider Identifier
1598919573
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26911 Issued in MN
Practice address
8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone
(651) 254-8580
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-3849 HI
Clinical Social Worker 1041C0700X 26911 MN Primary

Addresses

Primary practice location

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500

Mailing address

3146 Akahi St
Lihue, HI 96766-1105
Phone (808) 634-0431

Other practice location 1

3146 Akahi St
Lihue, HI 96766-1105
Phone (808) 634-0431

Other practice location 2

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone (651) 439-1234

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
I20190408000976 MN Practitioner - Clinical Social Worker 7517208259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-3849HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coleen Groen, LLC Clinical CurrentSince Apr 6, 2023 Accepting new patients
Canvas Health, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

7066 Stillwater Blvd N
Saint Paul, MN 55128

375 Orleans St E
Stillwater, MN 55082
Phone (651) 430-2720

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1598919573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3146 AKAHI ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661105",
            "telephone_number": "808-634-0431",
            "fax_number": "808-632-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550425500",
            "telephone_number": "651-254-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3146 Akahi St",
            "address_purpose": "LOCATION",
            "city": "Lihue",
            "state": "HI",
            "postal_code": "967661105",
            "country_code": "US",
            "telephone_number": "808-634-0431",
            "fax_number": "808-632-2010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Curve Crest Blvd W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826040",
            "country_code": "US",
            "telephone_number": "651-439-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROEN",
        "first_name": "COLEEN",
        "middle_name": "MACLEAN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-3849",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

Verify at the official NPI Registry.