Individual provider Active NPI

Stephanie Corrente, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1861056368
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24483 Issued in MN
Practice address
525 Portland Ave # Mc963
Minneapolis, MN 55415
Phone
(612) 384-5580
NPI assigned
Apr 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24483 MN Primary

Addresses

Primary practice location

525 Portland Ave # Mc963
Minneapolis, MN 55415

Mailing address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone (612) 384-5580

Other practice location 1

1010 Currie Ave
Minneapolis, MN 55403-1309
Phone (612) 384-5580

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
I20190624002505 MN Practitioner - Clinical Social Worker 1355675463 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County Clinical Current Accepting new patients
Hennepin County CurrentSince Aug 18, 2022 Accepting new patients

Locations

525 Portland Ave
Minneapolis, MN 55415
Phone (612) 348-8824

525 Portland Ave
#963
Minneapolis, MN 55415
Phone (612) 348-2233

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1861056368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-384-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-384-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Currie Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554031309",
            "country_code": "US",
            "telephone_number": "612-384-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORRENTE",
        "first_name": "STEPHANIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.