Individual provider Active NPI

Emily Ann Jaworski, MSW, LICSW

  • Clinical Social Worker
  • Plymouth, MN
National Provider Identifier
1750930681
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23688 Issued in MN
Practice address
9800 Shelard Pkwy Ste 110
Plymouth, MN 55441-6451
Phone
(952) 567-1459
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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 23688 MN Primary

Addresses

Primary practice location

9800 Shelard Pkwy Ste 110
Plymouth, MN 55441-6451

Mailing address

9069 Glacier Rd
St Bonifacius, MN 55375-1316
Phone (952) 567-1459

Other names 1

  • Emily Ann Willems Former name

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
I20241108000371 MN Practitioner - Clinical Social Worker 1658805015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

7767 Elm Creek Blvd N
Suite 220
Maple Grove, MN 55369-7067
Phone (651) 313-8080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23688MNMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Clinical CurrentSince Apr 13, 2026 Accepting new patients

Locations

4150 Olson Memorial Hwy
Ste 110
Golden Valley, MN 55422
Phone (763) 301-9998

7767 Elm Creek Blvd N
Ste 220
Maple Grove, MN 55369
Phone (612) 516-5660

1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 583-4447

12400 Whitewater Dr
Ste 140
Minnetonka, MN 55343
Phone (952) 479-0640

1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080

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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1750930681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9069 GLACIER RD",
            "city": "ST BONIFACIUS",
            "state": "MN",
            "postal_code": "553751316",
            "telephone_number": "952-567-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 SHELARD PKWY STE 110",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416451",
            "telephone_number": "952-567-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWORSKI",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WILLEMS",
            "middle_name": "ANN",
            "credential": "MSW, LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.