Individual provider Active NPI

Megan Lee Sibbert, MSW, LICSW

  • Clinical Social Worker
  • Brainerd, MN
National Provider Identifier
1639611338
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23336 Issued in MN
Practice address
823 Maple St
Brainerd, MN 56401
Phone
(218) 454-3826
Fax
(218) 454-1024
NPI assigned
Nov 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 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 23336 MN Primary

Addresses

Primary practice location

823 Maple St
Brainerd, MN 56401

Mailing address

14101 Inglewood Dr
Baxter, MN 56425-8515
Phone (218) 232-8118

Other practice location 1

14101 Inglewood Dr
Baxter, MN 56425-8515
Phone (218) 232-8118

Other names 1

  • Megan Lee Bock Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Pines Mental Health Center, Inc. CurrentSince Mar 26, 2017 Accepting new patients

Locations

13 3rd St NE
Aitkin, MN 56431
Phone (218) 928-8003

520 NW 5th St
Brainerd, MN 56401
Phone (218) 821-7818

823 Maple St
Brainerd, MN 56401
Phone (218) 454-3826

1906 5th Ave SE
Little Falls, MN 56345
Phone (320) 492-2946

16 9th St SE
Long Prairie, MN 56347
Phone (320) 732-6602

200 4th St NE
Staples, MN 56479
Phone (218) 541-5043

11 2nd St SW
Ste 1
Wadena, MN 56482
Phone (218) 631-1714

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": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1639611338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 INGLEWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258515",
            "telephone_number": "218-232-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 MAPLE ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "56401",
            "telephone_number": "218-454-3826",
            "fax_number": "218-454-1024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14101 Inglewood Dr",
            "address_purpose": "LOCATION",
            "city": "Baxter",
            "state": "MN",
            "postal_code": "564258515",
            "country_code": "US",
            "telephone_number": "218-232-8118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBBERT",
        "first_name": "MEGAN",
        "middle_name": "LEE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "BOCK",
            "middle_name": "LEE",
            "credential": "MSW, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.