Individual provider Active NPI

Linda Dene Rounsville, LICSW

  • Clinical Social Worker
  • Bemidji, MN
National Provider Identifier
1609369768
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25736 Issued in MN
Practice address
112 1St St W
Bemidji, MN 56601-4002
Phone
(218) 888-8032
Fax
(218) 888-8033
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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 25736 MN Primary

Addresses

Primary practice location

112 1St St W
Bemidji, MN 56601-4002

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789

Other names 1

  • Linda Dene Krassau Former name

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
I20200324000808 MN Practitioner - Clinical Social Worker 6406284553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

112 1St St W
Suite 204 205
Bemidji, MN 56601-4002
Phone (218) 888-8032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solstice Therapy and Wellness Clinical CurrentSince Jan 2, 2025 Accepting new patients
Nystrom & Associates, LTD Clinical CurrentSince Nov 21, 2023 Accepting new patients

Locations

112 1st St W
Ste 204205
Bemidji, MN 56601
Phone (218) 888-8032

112 1st St W
Bemidji, MN 56601
Phone (218) 888-8032

4 E 43rd St
Ste 204
Minneapolis, MN 55409
Phone (612) 429-7042

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1609369768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 1ST ST W",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014002",
            "telephone_number": "218-888-8032",
            "fax_number": "218-888-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNSVILLE",
        "first_name": "LINDA",
        "middle_name": "DENE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "KRASSAU",
            "middle_name": "DENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.