Nicole Marie Deprez, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24203 Issued in MN

Practice address

249 5TH St E
Tracy, MN 56175-1536

Phone

(507) 629-8400

NPI assigned

Apr 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Health NetworkGroup PAC ID 6800707100, shared by 49 NPIs, 357 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sanford Health Network

  • Critical Access Hospital
  • Tracy, MN
  • NPI 1003851171
  Medicare reassignment NPD
• Sanford Health Network

  • Family Medicine Physician
  • Tracy, MN
  • NPI 1699869875
  Medicare reassignment NPD
• Sanford Health Network

  • Critical Access Hospital
  • Westbrook, MN
  • NPI 1942253547
  Medicare reassignment NPD
• Sanford Health Network

  • Family Medicine Physician
  • Westbrook, MN
  • NPI 1437196490
  NPD
• Sanford Health Network

  • Rural Health Clinic/Center
  • Mountain Lake, MN
  • NPI 1568469039
  NPD

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1790471027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 5TH ST E",
            "city": "TRACY",
            "state": "MN",
            "postal_code": "561751536",
            "telephone_number": "507-629-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPREZ",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Lynn Busmann, NP-C
• Kristy Marie Campbell, LPC
• Elishia Ann Christians, FNP
• Maggie Currie
• Angela Lee Deadrick, LICSW
• Engelkes, LLC
• Mikaela Elizabeth Erickson, PA-C
• Denise Anne Evers, D.C.
• Mark Allen Evers
• Jon Allen Heezen, DDS

• Clinical Social Worker in Tracy, MN
• Providers in Tracy, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.