Maita Yang, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23020 Issued in MN

Practice address

11468 Marketplace Dr N Ste 600-1267
Champlin, MN 55316-3872

Phone

(763) 267-2520

NPI assigned

Nov 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindful Healing Therapeutic Services P.L.L.C.

  • Mental Health Counselor
  • Elk River, MN
  • NPI 1023867025
  NPD Authorized official
• Family Support Services Inc.

  dba Sagent Behavioral Health

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD
• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  NPD

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1881302172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9994 190TH AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302459",
            "telephone_number": "763-267-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11468 MARKETPLACE DR N STE 600-1267",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163872",
            "telephone_number": "763-267-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MAITA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2024-05-14",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Widestrom
• Wildflower Speech
• Lisa Wilke, PSYD
• Michelle Rose Wilkening, MD
• Mary M Wilson, MD
• Jan Elaine Youngblood, APRN, FNP-C
• Hamza Yusuf
• Anthony Zabel, O.D.
• Zeor Healthcare LLC
• Jill Renae Zimmermann, RN, IBCLC, PHN

• Clinical Social Worker in Champlin, MN
• Providers in Champlin, 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 May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.