Individual provider Active NPI

Jessica Lauree Milbrath, LICSW

  • Social Worker
  • Saint Paul, MN
National Provider Identifier
1679160717
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
27291 Issued in MN
Practice address
400 Selby Ave Ste S
Saint Paul, MN 55102-4520
Phone
(651) 380-3723
NPI assigned
Dec 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 27291 MN Primary

Addresses

Primary practice location

400 Selby Ave Ste S
Saint Paul, MN 55102-4520

Mailing address

1930 Covington LN
Eagan, MN 55122-2696
Phone (651) 380-3723

Other practice location 1

1930 Covington Ln
Eagan, MN 55122-2696
Phone (651) 380-3723

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
I20210317002222 MN Practitioner - Clinical Social Worker 6709292782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27291MNMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1679160717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 COVINGTON LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222696",
            "telephone_number": "651-380-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SELBY AVE STE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024520",
            "telephone_number": "651-380-3723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Covington Ln",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551222696",
            "country_code": "US",
            "telephone_number": "651-380-3723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILBRATH",
        "first_name": "JESSICA",
        "middle_name": "LAUREE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "27291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.