Active NPI
Jill Michele Stiber, MSSW, LICSW, BCD
- Clinical Social Worker
- Minnetonka, MN
National Provider Identifier
1861560328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17096
- Practice address
- 13100 Wayzata Blvd
Suite 400
Minnetonka, MN 55305-1802 - Phone
- (952) 546-0616
- Fax
- (952) 573-1778
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17096 | MN | Primary |
Addresses
Primary practice location
13100 Wayzata Blvd
Suite 400
Minnetonka, MN 55305-1802
Mailing address
4006 Basswood Rd
St Louis Park, MN 55416-3845
Phone (952) 929-1398
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 508R3ST 3G377LA SW | Other | MN | BLUE CROSS BLUE SHIELD |
| HP52398 | Other | MN | HEALTH PARTNERS |
| 876408500 | Other | MN | MEDICAL ASSISTANCE |
Other names 1
- Ms. Jill Michele Slavin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Women'S Group Therapy | Past | Accepting new patients |
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.
-
- Professional Counselor
- Minnetonka, MN
- NPI 1831576453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861560328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4006 BASSWOOD RD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554163845",
"telephone_number": "952-929-1398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13100 WAYZATA BLVD",
"address_2": "SUITE 400",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553051802",
"telephone_number": "952-546-0616",
"fax_number": "952-573-1778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIBER",
"first_name": "JILL",
"middle_name": "MICHELE",
"credential": "MSSW, LICSW, BCD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "17096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "508R3ST 3G377LA SW",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP52398",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "876408500",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "SLAVIN",
"middle_name": "MICHELE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.