Michael Richard Anderson, LICSW
Individual provider Active NPI Clinical Social Worker · Crookston, MN
NPI 1619936739 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1619936739
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 12676 (MN)
- Practice address
- 603 Bruce St
Crookston, MN 56716 - Phone
- (218) 281-3940
- Fax
- (218) 281-6261
- NPI assigned
- Mar 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- University of North Dakota School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alluma Inc
Practice addresses (Care Compare)
603 Bruce St
Crookston, MN 56716-2914
Phone (218) 281-3940
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110504000734 | MN | Practitioner - Clinical Social Worker | 9234314378 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alluma, Inc. | Current |
Accepting new patients |
Locations
603 Bruce St
Crookston, MN 56716
Phone (218) 281-3940
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12676 | MN | Yes |
Addresses
Primary practice location
603 Bruce St
Crookston, MN 56716
Mailing address
603 Bruce St
PO Box 603
Crookston, MN 56716-0603
Phone (218) 281-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116597 | Other | MN | UCARE MINNESOTA |
| 6248695 | Other | UBH MEDICA | |
| 1029836 | Other | PREFERRED ONE | |
| 17763 | Other | ND | BCBS OF ND |
| 9H593AN | Other | MN | BCBSBHSI |
| HP28518 | Other | HEALTH PARTNERS |
Other providers in Crookston, MN
- Cheri Lynn Ames
- Debra Kay Ames
- Brenda Melissia Anderson
- Casandra Kay Anderson
- Lisa Danielle Wikoff Anderson
- Emily Ann Andrews
- Janelle Bernice Artmann
- Rita Jane Aune
- Aura Azarcon
- B & C of Crookston Inc
All providers in Crookston, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.