Kassandra Nicole Placencio
Individual provider Active NPI Clinical Social Worker · Grand Forks, ND
NPI 1629952858 · NPPES record last updated Aug 1, 2025
Key facts
- NPI
- 1629952858
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 3674 S Washington St
Grand Forks, ND 58201 - Phone
- (701) 732-2538
- Fax
- (701) 732-2501
- NPI assigned
- Aug 1, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Organizations & group practices 27
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Peterson Medical Clinics LLC
Practice addresses (Care Compare)
205 E Benson Blvd
Suite 401
Anchorage, AK 99503-4019
Phone (701) 205-3000
3674 S Washington St
Grand Forks, ND 58201-5766
Phone (701) 205-3000
519 Anne St NW
Suite a
Bemidji, MN 56601-4277
Phone (701) 205-3000
859 Pine More Dr
Brownsville, TX 78526-4276
Phone (701) 205-3000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in AK, MN, ND, TX
- 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 |
|---|---|---|---|---|
| I20250922001419 | AK | Practitioner - Clinical Social Worker | 8729582762 | Reassigns benefits to 3 organizations |
| I20251010003235 | MN | Practitioner - Clinical Social Worker | 8729582762 | Reassigns benefits to 1 organization |
| I20251030004065 | ND | Practitioner - Clinical Social Worker | 8729582762 | Reassigns benefits to 1 organization |
| I20260101000170 | TX | Practitioner - Clinical Social Worker | 8729582762 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35443 | MN | MD | Gastroenterology Physician |
Practice roles
Locations
3380 C St
Ste 107
Anchorage, AK 99503
Phone (907) 277-1440
205 E Benson Blvd
Ste 401
Anchorage, AK 99503
519 Anne St NW
Ste A
Bemidji, MN 56601
Phone (218) 444-5700
4501 15th Ave SW
Ste 105
Fargo, ND 58103
3674 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2538
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
3674 S Washington St
Grand Forks, ND 58201
Mailing address
PO Box 5210
Grand Forks, ND 58206-5210
Phone (701) 205-3000
Other providers in Grand Forks, ND
- Karen Rae Pietras
- Amy Louise Pinkerton
- Bridget Pinoniemi
- Pivot Nutrition Coaching
- Alessandra Pizzolato
- Plains Chiropractic & Acupuncture PC
- Kevin John Plekan
- Nicole Plummer
- Jade Podell
- Christopher Lee Podoll
All providers in Grand Forks, ND · Clinical Social Worker in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2025. 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.