Jeanne Martha Abicht, MSW LICSW
Individual provider Active NPI Clinical Social Worker · Maple Grove, MN
NPI 1821566498 · NPPES record last updated May 2, 2019
Key facts
- NPI
- 1821566498
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 23823 (MN)
- Practice address
- 12918 63Rd Ave N
Maple Grove, MN 55369-6001 - Phone
- (763) 219-9966
- NPI assigned
- Nov 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Collaborative Counseling LLC
Practice addresses (Care Compare)
12918 63Rd Ave N
Maple Grove, MN 55369-6001
Phone (763) 210-9966
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240301002448 | MN | Practitioner - Clinical Social Worker | 8022453943 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23823 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Counseling LLC | Current |
Accepting new patients |
Locations
12918 63rd Ave N
Maple Grove, MN 55369
Phone (952) 999-1959
901 4th St
Hudson, WI 54016
Phone (651) 492-8498
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 23823 | MN | Yes |
Addresses
Primary practice location
12918 63Rd Ave N
Maple Grove, MN 55369-6001
Mailing address
12918 63Rd Ave N
Maple Grove, MN 55369-6001
Phone (763) 210-9966
Other providers in Maple Grove, MN
- 4 Counsel, P.a.
- Aisha Abdi
- Raheema Mohamed Abdi
- Yusra Mohamed Abdirahman
- Kelly Abell
- Access Behavior Services
- Accord Health, PLLC
- Accorde Orthodontists
- Stephanie Acosta
- Naomi Jain Adams
All providers in Maple Grove, 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 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.