Gloria Andreasen, LICSW – Clinical Social Worker

Key facts

NPI: 1811099138
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 16694 (MN)
Practice address: 9 4TH Street
Windom, MN 56101
Phone: (507) 831-2090
Fax: (507) 831-2090
NPI assigned: Sep 5, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Southwestern Mental Health Center Inc Mental Health Clinic/Center (Including Community Mental Health Center) · Luverne, MN · NPI 1487654562

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
16694	MN	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Southwestern Mental Health Center Inc		Past since Aug 15, 2016	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	16694	MN	Yes

Addresses

Primary practice location

9 4TH Street
Windom, MN 56101

Mailing address

216 E Luverne St
PO Box 686
Luverne, MN 56156-1610
Phone (507) 283-9511

Other identifiers

Identifier	Type	State	Issuer
492642000	Medicaid	MN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 9, 2008.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1811099138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 E LUVERNE ST",
            "address_2": "PO BOX 686",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561610",
            "telephone_number": "507-283-9511",
            "fax_number": "507-283-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 4TH STREET",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "56101",
            "telephone_number": "507-831-2090",
            "fax_number": "507-831-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREASEN",
        "first_name": "GLORIA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "492642000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windom, MN

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

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.