Anoka Psychological Services, PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7835 Issued in MN

Legal business name

ANOKA PSYCHOLOGICAL SERVICES, PA

Practice address

11427 Hanson Blvd NW
Coon Rapids, MN 55433-3719

Phone

(763) 754-1531

Fax

(763) 754-3155

NPI assigned

Apr 10, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dianne M Gordon, LICSWNPI 1154544096

Title

Ceo

Phone

(763) 754-1531

Specialties & licenses 7

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dianne M Gordon, LICSW

  • Clinical Social Worker
  • Coon Rapids, MN
  • NPI 1154544096
  NPD (past) Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1730302894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11427 HANSON BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333719",
            "telephone_number": "763-754-1531",
            "fax_number": "763-754-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11427 HANSON BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333719",
            "telephone_number": "763-754-1531",
            "fax_number": "763-754-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANOKA PSYCHOLOGICAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-754-1531",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "3751",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "3751",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "3751",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "3751",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "3751",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MN",
            "license": "3751",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "7835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "401G6AN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "402G3AN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "110367",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Angle, CRNA
• Anoka - Champlin Meals on Wheels
• Anoka Area Family Medicine Clinic, PA
• Anoka Cares, LLC
• Anoka Cares, LLC
• Julia Antiel
• Mariam Anwar, MD
• Megan Marie Appelwick, OT
• Applen Home Care
• Maria Guadalupe Aragon

• Clinical Social Worker in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.