Individual provider Active NPI

Cindy A T Happe, MSW LICSW

  • Clinical Social Worker
  • St Cloud, MN
National Provider Identifier
1720037575
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15109 Issued in MN
Practice address
1900 Centracare Circle
St Cloud, MN 56303
Phone
(320) 255-5796
Fax
(320) 229-5179
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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 15109 MN Primary

Addresses

Primary practice location

1900 Centracare Circle
St Cloud, MN 56303

Mailing address

3315 Roosevelt Rd
Suite 200a
St Cloud, MN 56301
Phone (320) 229-4069

Other identifiers 1

IdentifierTypeStateIssuer
273639000MedicaidMN

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
I20080702000447 MN Practitioner - Clinical Social Worker 5991877144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2653 County Rd
Suite 74
Saint Cloud, MN 56301-2205
Phone (320) 229-4069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15109MNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Up, LLC CurrentSince Jan 1, 2013 Accepting new patients

Locations

3315 Roosevelt Rd
Ste 200A
Saint Cloud, MN 56301
Phone (320) 229-4069

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1720037575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 ROOSEVELT RD",
            "address_2": "SUITE 200A",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-229-4069",
            "fax_number": "320-229-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIRCLE",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-255-5796",
            "fax_number": "320-229-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAPPE",
        "first_name": "CINDY",
        "middle_name": "A T",
        "credential": "MSW LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273639000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Cloud, MN

Sources for this page

Verify at the official NPI Registry.