Individual provider Active NPI

Larisa Anne Marie Breid, MSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1790078657
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20348 Issued in MN
Practice address
1 Veterans Dr
Mail Code 116a
Minneapolis, MN 55417-2309
Phone
(612) 467-2238
Fax
(612) 467-1747
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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 20348 MN Primary

Addresses

Primary practice location

1 Veterans Dr
Mail Code 116a
Minneapolis, MN 55417-2309

Mailing address

1 Veterans Dr
Mail Code 116a
Minneapolis, MN 55417-2309
Phone (612) 467-2238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20348MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1790078657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "address_2": "MAIL CODE 116A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-2238",
            "fax_number": "612-467-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VETERANS DR",
            "address_2": "MAIL CODE 116A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-467-2238",
            "fax_number": "612-467-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREID",
        "first_name": "LARISA",
        "middle_name": "ANNE MARIE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.