Elissa Kuznia Anderson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16558 Issued in MN

Practice address

515 Bridge St
Park Rapids, MN 56470

Phone

(218) 366-9229

Fax

(218) 237-2520

NPI assigned

May 1, 2007

Last updated

Apr 9, 2019By the provider in NPPES

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Country Associates, Inc.Group PAC ID 3779610472, 11 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Country Associates, Inc.

  • Community/Behavioral Health Agency
  • Park Rapids, MN
  • NPI 1104151588
  Medicare reassignment Care Compare group NPD
• Peterson Medical Clinics, LLC

  dba Rural Psychiatry Associates

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1699295774
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1821219205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 BELTRAMI AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013010",
            "telephone_number": "218-444-2845",
            "fax_number": "218-444-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BRIDGE ST",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "56470",
            "telephone_number": "218-366-9229",
            "fax_number": "218-237-2520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Beltrami Ave NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566013010",
            "country_code": "US",
            "telephone_number": "218-444-2845",
            "fax_number": "218-444-2847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELISSA",
        "middle_name": "KUZNIA",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delores Ann Alleckson, NP
• Brittany Ann Almquist, PA-C
• Kia Danielle Alton, SLP
• David Eric Andersen, D.D.S.
• Deborah A Anderson, LPC
• Rita Jean Anderson, MA, LPCC, LADC
• Sara Anderson, OTR/L
• Shawn D. Anderson, B.S.
• Anesthesia Care Team, P.a.
• Loretta Jayne Bach Gansen, L.A.D.C.

• Clinical Social Worker in Park Rapids, MN
• Providers in Park Rapids, 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 Apr 9, 2019; 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.