Melissa Ann George-Humphrey, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14486 Issued in MN

Practice address

522 Beltrami Ave NW
Suite 116
Bemidji, MN 56601-3001

Phone

(218) 760-2222

Fax

(218) 444-7105

NPI assigned

Oct 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1629405915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 BELTRAMI AVE NW",
            "address_2": "SUITE 116",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013001",
            "telephone_number": "218-760-2222",
            "fax_number": "218-444-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 BELTRAMI AVE NW",
            "address_2": "SUITE 116",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013001",
            "telephone_number": "218-760-2222",
            "fax_number": "218-444-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE-HUMPHREY",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288620100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.