Individual provider Active NPI

Chelsey Marie Harju, LICSW

  • Clinical Social Worker
  • Hermantown, MN
National Provider Identifier
1760771273
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19207 Issued in MN
Practice address
4140 Richard Ave Ste 312
Hermantown, MN 55811-3309
Phone
(218) 390-8733
NPI assigned
Apr 5, 2011
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 19207 MN Primary

Addresses

Primary practice location

4140 Richard Ave Ste 312
Hermantown, MN 55811-3309

Mailing address

4140 Richard Ave Ste 312
Hermantown, MN 55811-3309
Phone (218) 390-8733

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
I20170823002883 MN Practitioner - Clinical Social Worker 5799057915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19207MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsey Harju, PLLC Clinical CurrentSince Sep 1, 2024 Accepting new patients
Jessica Podpeskar Clinical PastSince Sep 1, 2024 Accepting new patients

Locations

4140 Richard Ave
Ste 312
Hermantown, MN 55811
Phone (218) 390-8733

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1760771273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 RICHARD AVE STE 312",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558113309",
            "telephone_number": "218-390-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 RICHARD AVE STE 312",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558113309",
            "telephone_number": "218-390-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARJU",
        "first_name": "CHELSEY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermantown, MN

Sources for this page

Verify at the official NPI Registry.