Linda Lee Pagenkopf, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14352 Issued in MN

Practice address

2903 15TH St S
Moorhead, MN 56560

Phone

(218) 331-2032

NPI assigned

Jan 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Life Choices Counseling

  • Clinical Social Worker
  • Detroit Lakes, MN
  • NPI 1164753265
  NPD (past)

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1861639049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 15TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605111",
            "telephone_number": "218-331-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 15TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-331-2032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28908 80th Ave S",
            "address_purpose": "LOCATION",
            "city": "Hawley",
            "state": "MN",
            "postal_code": "565498977",
            "country_code": "US",
            "telephone_number": "701-205-2592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGENKOPF",
        "first_name": "LINDA",
        "middle_name": "LEE",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SOCIAL WORK",
            "identifier": "14352",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sadiyo Aden Osman
• Taryn M Osowski
• Peter Baba Otoo
• Ayla S Owens
• McKenna Paeper
• Max Pajari
• Stephanie Leigh Palanuk, RN
• Katie Palloch
• Madison Paul
• Nancy A Paul, MS CCCSLP

• Clinical Social Worker in Moorhead, MN
• Providers in Moorhead, 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 Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.