Individual provider Active NPI

Alicia Marie Newman, MSW, LICSW

  • Clinical Social Worker
  • West St Paul, MN
National Provider Identifier
1609434547
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22023 Issued in MN
Practice address
149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238
Phone
(651) 450-0860
Fax
(651) 450-0759
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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 22023 MN Primary

Addresses

Primary practice location

149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

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
I20190702000342 MN Practitioner - Clinical Social Worker 0345574992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians

Practice addresses (Care Compare)

149 Thompson Ave E
Suite 150
West St Paul, MN 55118-3238
Phone (651) 450-0860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22023MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinic of Psychology Inc CurrentSince May 26, 2019 Accepting new patients

Locations

4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033

4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033

149 Thompson Ave E
Ste 150
West St Paul, MN 55118
Phone (651) 450-0860

Organizations & group practices 1

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1609434547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 THOMPSON AVE E STE 150",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183238",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West St Paul, MN

Sources for this page

Verify at the official NPI Registry.