Donna Anderson, LICSW
Individual provider Active NPI Clinical Social Worker · Roseville, MN
NPI 1669491908 · NPPES record last updated Nov 8, 2011
Key facts
- NPI
- 1669491908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 1288 (MN)
- Practice address
- 1711 County Road B W
Rosewood Office Plaza Suite 210S
Roseville, MN 55113-4057 - Phone
- (651) 621-2495
- Fax
- (651) 621-2496
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1711 County Rd B W
Suite 210S
Roseville, MN 55113-4069
Phone (651) 621-2495
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 |
|---|---|---|---|---|
| I20110113001183 | MN | Practitioner - Clinical Social Worker | 9234328790 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1288 | MN | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1288 | MN | Yes |
Addresses
Primary practice location
1711 County Road B W
Rosewood Office Plaza Suite 210S
Roseville, MN 55113-4057
Mailing address
1711 County Road B W
Rosewood Office Plaza Suite 210S
Roseville, MN 55113-4057
Phone (651) 621-2495
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62-20080 | Other | MN | UBH |
| 0G034AN | Other | MN | BC-BS |
| 990990570030 | Other | MN | PREFERRED ONE |
| 106222 | Other | MN | UC |
| 658755100 | Medicaid | MN |
Other providers in Roseville, MN
- Amy Sue Andersen
- Ruth Carol Anderson-Benge
- Ashley Christine Anderson
- Christopher Stephen Anderson
- Clarissa J. Anderson
- Jill Anderson
- Kerry Lynn Anderson
- Marnna Anderson
- Megan Marie Anderson
- Shari Marie Anderson
All providers in Roseville, 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 Nov 8, 2011. 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.