Individual provider Active NPI

Rebecca Kay Neeck, LICSW

  • Clinical Social Worker
  • New Brighton, MN
National Provider Identifier
1659655884
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19729 Issued in MN
Practice address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone
(651) 379-1718
Fax
(651) 379-1738
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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 19729 MN Primary

Addresses

Primary practice location

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786

Mailing address

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 379-1718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120110000112 MN Practitioner - Clinical Social Worker 2163698382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

1900 Silver Lake NWRD
Suite 110
New Brighton, MN 55112-1789

1900 Silver Lake Rd NW
New Brighton, MN 55112-1789
Phone (651) 628-9566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19729MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical CurrentSince Mar 10, 2014 Accepting new patients
Emily Program P C CurrentSince Oct 16, 2011 Accepting new patients
Family Support Services Inc. PastSince May 30, 2023 Accepting new patients

Locations

11660 Round Lake Blvd NW
Coon Rapids, MN 55433
Phone (763) 317-0718

1702 Miller Trunk Hwy
Ste 209
Duluth, MN 55811
Phone (218) 318-1348

114 Main St N
Ste 201B
Hutchinson, MN 55350
Phone (320) 753-0778

17685 Juniper Path
Ste 303
Lakeville, MN 55044
Phone (952) 214-8959

201 N Broad St
Ste 200
Mankato, MN 56001
Phone (507) 200-2624

13603 80th Cir N
Maple Grove, MN 55369
Phone (763) 274-3120

1856 Beam Ave
#200
Maplewood, MN 55109
Phone (651) 661-6550

1101 E 78th St
Ste 100
Minneapolis, MN 55420
Phone (952) 234-8604

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

2265 Como Ave
Saint Paul, MN 55108

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

101 Dehler Dr
Sartell, MN 56377
Phone (320) 253-3512

1811 Weir Dr
Ste 270
Woodbury, MN 55125
Phone (651) 243-6087

Organizations & group practices 3

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": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1659655884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-379-1718",
            "fax_number": "651-379-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-379-1718",
            "fax_number": "651-379-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEECK",
        "first_name": "REBECCA",
        "middle_name": "KAY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.