Active NPI
Amy Lyn Archer, L.I.C.S.W.
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1801825112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12919
- Practice address
- 1 Veterans Dr
#122
Minneapolis, MN 55417-2309 - Phone
- (612) 467-3238
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12919 | MN | Primary |
Addresses
Primary practice location
1 Veterans Dr
#122
Minneapolis, MN 55417-2309
Mailing address
3890 Worchester Dr
Eagan, MN 55123-1651
Phone (651) 688-6468
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12919 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801825112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3890 WORCHESTER DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551231651",
"telephone_number": "651-688-6468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VETERANS DR",
"address_2": "#122",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554172309",
"telephone_number": "612-467-3238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "AMY",
"middle_name": "LYN",
"name_prefix": "Mrs.",
"credential": "L.I.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "12919",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.