Individual provider Active NPI

Trina N Givens-Henry, LICSW

  • Clinical Social Worker
  • Eden Prairie, MN
National Provider Identifier
1669602496
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17605 Issued in MN
Practice address
18397 Chennault Way
Eden Prairie, MN 55346-1124
Phone
(952) 975-0945
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 17605 MN Primary

Addresses

Primary practice location

18397 Chennault Way
Eden Prairie, MN 55346-1124

Mailing address

18397 Chennault Way
Eden Prairie, MN 55346-1124
Phone (952) 975-0945

Other practice location 1

300 S 6th St
Government Center A16
Minneapolis, MN 55487-0999
Phone (612) 596-8623

Other identifiers 1

IdentifierTypeStateIssuer
1841650439MedicaidMN

Other names 1

  • Trina N Givens Former name

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
I20220802001335 MN Practitioner - Clinical Social Worker 9638551476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6385 Old Shady Oak Rd
Suite 250
Eden Prairie, MN 55344-7705
Phone (612) 216-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing & Restoration Consulting LLC CurrentSince Apr 28, 2015 Accepting new patients

Locations

6385 Old Shady Oak Rd
Ste 250
Eden Prairie, MN 55344
Phone (612) 226-0907

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669602496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18397 CHENNAULT WAY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553461124",
            "telephone_number": "952-975-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18397 CHENNAULT WAY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553461124",
            "telephone_number": "952-975-0945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S 6th St",
            "address_2": "Government Center A16",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554870999",
            "country_code": "US",
            "telephone_number": "612-596-8623",
            "fax_number": "612-677-6460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIVENS-HENRY",
        "first_name": "TRINA",
        "middle_name": "N",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841650439",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRINA",
            "last_name": "GIVENS",
            "middle_name": "N",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.