Individual provider Active NPI

Alissa Kaasa

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1700265246
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22716 Issued in MN
Practice address
3621 42ND Ave S
Minneapolis, MN 55406-2814
Phone
(612) 578-5181
NPI assigned
May 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2015

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 22716 MN Primary

Addresses

Primary practice location

3621 42ND Ave S
Minneapolis, MN 55406-2814

Mailing address

3621 42ND Ave S
Minneapolis, MN 55406-2814

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
I20160222000615 MN Practitioner - Clinical Social Worker 1658676143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poplar Grove Counseling, PLLPGroup PAC ID 8426353145, 2 clinicians

Practice addresses (Care Compare)

3011 36TH Ave S
Suite 9
Minneapolis, MN 55406-2800
Phone (651) 335-3799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Grove Counseling, PLLP Clinical CurrentSince Jan 9, 2016 Accepting new patients

Locations

3011 36th Ave S
Ste 9
Minneapolis, MN 55406
Phone (612) 399-9230

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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1700265246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 42ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062814",
            "telephone_number": "612-578-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAASA",
        "first_name": "ALISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.