Individual provider Active NPI

Brittney Baxter Dameron, LICSW, LISW

  • Clinical Social Worker
  • Albert Lea, MN
National Provider Identifier
1750714853
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
33130 Issued in MN
Practice address
18330 US Highway 69
Albert Lea, MN 56007-5589
Phone
(712) 624-4434
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 008219 IA
Clinical Social Worker 1041C0700X 008219 IA
Clinical Social Worker 1041C0700X 33130 MN Primary

Addresses

Primary practice location

18330 US Highway 69
Albert Lea, MN 56007-5589

Mailing address

18330 US Highway 69
Albert Lea, MN 56007-5589
Phone (319) 429-2807

Other names 1

  • Brittney Baxter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181109000453 IA Practitioner - Clinical Social Worker 8224382296 Reassigns benefits to 1 organization
I20241205004158 MN Practitioner - Clinical Social Worker 8224382296 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

Practice addresses (Care Compare)

18330 US Hwy 69
Albert Lea, MN 56007-5589
Phone (712) 624-4434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33130MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Place, Inc. Clinical CurrentSince Sep 30, 2018 Accepting new patients

Organizations & group practices 2

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": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1750714853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18330 US HIGHWAY 69",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560075589",
            "telephone_number": "319-429-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18330 US HIGHWAY 69",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560075589",
            "telephone_number": "712-624-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXTER DAMERON",
        "first_name": "BRITTNEY",
        "credential": "LICSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "008219",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008219",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "33130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTNEY",
            "last_name": "BAXTER",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.