Individual provider Active NPI

Anna Christine Bailey, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1851015192
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20484 Issued in MN
Practice address
2215 E Lake St FL 5
Minneapolis, MN 55407-4385
Phone
(612) 596-9438
NPI assigned
Sep 29, 2022
Last updated
Oct 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 20484 MN
Clinical Social Worker 1041C0700X 20484 MN Primary

Addresses

Primary practice location

2215 E Lake St FL 5
Minneapolis, MN 55407-4385

Mailing address

7624 Morgan Ave N
Brooklyn Park, MN 55444-2428
Phone (763) 607-7340

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221121002558 MN Practitioner - Clinical Social Worker 5193193282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

2215 E Lake St
Minneapolis, MN 55407-4385
Phone (612) 596-9438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20484MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County CurrentSince Nov 7, 2022 Accepting new patients
Hennepin County Clinical Current Accepting new patients
Hennepin County CurrentSince Nov 7, 2022 Accepting new patients

Locations

2215 E Lake St
Minneapolis, MN 55407
Phone (612) 596-0900

2215 E Lake St
Fl 5
Minneapolis, MN 55407
Phone (612) 543-2298

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1851015192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7624 MORGAN AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554442428",
            "telephone_number": "763-607-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E LAKE ST FL 5",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074385",
            "telephone_number": "612-596-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "ANNA",
        "middle_name": "CHRISTINE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "20484",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.