Individual provider Active NPI

Juliane Evonne Boraas, LICSW

  • Clinical Social Worker
  • Willmar, MN
National Provider Identifier
1619658903
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29672 Issued in MN
Practice address
2320 Highway 12 E Ste 2
Willmar, MN 56201-5811
Phone
(320) 214-9692
NPI assigned
Jul 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 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 29672 MN Primary

Addresses

Primary practice location

2320 Highway 12 E Ste 2
Willmar, MN 56201-5811

Mailing address

2320 Highway 12 E Ste 2
Willmar, MN 56201-5811
Phone (320) 214-9692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29672MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Minnesota Family Services CurrentSince Jul 31, 2023 Accepting new patients

Locations

2320 Highway 12 E
Ste 2
Willmar, MN 56201
Phone (320) 214-9692

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1619658903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 HIGHWAY 12 E STE 2",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562015811",
            "telephone_number": "320-214-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 HIGHWAY 12 E STE 2",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562015811",
            "telephone_number": "320-214-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORAAS",
        "first_name": "JULIANE",
        "middle_name": "EVONNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.