Julie Humbert MSW Licsw Inc

Organization Active NPI Community/Behavioral Health Agency · Cold Spring, MN

NPI 1679987358 · NPPES record last updated Jun 20, 2014

Key facts

NPI: 1679987358
Entity type: Organization (NPI type 2)
Primary specialty: Community/Behavioral Health Agency 251S00000X
License: 15465 (MN)
Legal business name: JULIE HUMBERT MSW LICSW INC
Practice address: 1302 4TH St S
Cold Spring, MN 56320-2336
Phone: (320) 250-2132
Fax: (320) 685-3076
NPI assigned: Jun 20, 2014
Organization subpart: No

Authorized official

Name: Ms. Julie Humbert NPI 1528151073
Title: Therapist/Owner
Phone: (320) 250-2132

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Julie Humbert, LICSW Clinical Social Worker · Minnetrista, MN · NPI 1528151073

Medicare reassignment NPD Authorized official MN

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MN

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20140624000632	MN	Part B Supplier - Clinic/Group Practice	4587888011	Receives reassigned benefits from 1 practitioner Practice locations: Benson, MN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community/Behavioral Health Agency	251S00000X	15465	MN	Yes

Addresses

Primary practice location

1302 4TH St S
Cold Spring, MN 56320-2336

Mailing address

1302 4TH St S
Cold Spring, MN 56320-2336
Phone (320) 250-2132

Other identifiers

Identifier	Type	State	Issuer
152466	Other	MN	UCARE
206991100	Medicaid	MN
807683925	Other	MN	MEDICA/OPTUM

Other providers in Cold Spring, MN

All providers in Cold Spring, MN · Community/Behavioral Health Agency in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2014. 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.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.