Candis S Astolfi, LICSW

Individual provider Active NPI Clinical Social Worker · Moorhead, MN

NPI 1760710784 · NPPES record last updated Dec 6, 2022

Key facts

NPI
1760710784
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
11264 (MN)
Practice address
2405 8TH St S Ste 200
Moorhead, MN 56560-4200
Phone
(218) 331-4866
NPI assigned
Dec 2, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom and Associates Counseling Wi SC (108 clinicians)

Practice addresses (Care Compare)

5354 42ND St S
Suite B
Fargo, ND 58104-4032
Phone (701) 941-4503

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in ND, MN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160829001682 ND Practitioner - Clinical Social Worker 1456646538 Reassigns benefits to 1 organization
I20170210001500 MN Practitioner - Clinical Social Worker 1456646538 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4829NDMDPharmacist
11264MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. Current
since May 14, 2023
Accepting new patients
Nystrom & Associates, LTD Clinical Current
since Feb 13, 2023
Accepting new patients
Family Support Services Inc. Current
since May 30, 2023
Accepting new patients
Lakeland Mental Health Center Past
since Sep 27, 2021
Accepting new patients

Locations

13045 Falcon Dr
#100
Brainerd, MN 56425
Phone (218) 203-6282

332 W Superior St
Ste 300
Duluth, MN 55802
Phone (218) 481-9408

2405 8th St S
Ste 200
Moorhead, MN 56560
Phone (218) 331-4866

9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619

124 Tyler Rd S
Red Wing, MN 55066
Phone (651) 977-5001

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

101 Dehler Dr
Sartell, MN 56377
Phone (320) 253-3512

5354 42nd St S
Ste B
Fargo, ND 58104
Phone (701) 501-8014

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4829 ND
Clinical Social Worker 1041C0700X 11264 MN Yes

Addresses

Primary practice location

2405 8TH St S Ste 200
Moorhead, MN 56560-4200

Mailing address

2405 8TH St S Ste 200
Moorhead, MN 56560-4200
Phone (218) 331-4866

Other providers in Moorhead, MN

All providers in Moorhead, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.