Emily Clements, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

3490 Lexington Ave N Ste 205
Shoreview, MN 55126-8044

Phone

(651) 486-3808

Fax

(651) 486-3858

NPI assigned

Mar 30, 2022

Last updated

Mar 30, 2022By the provider in NPPES

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Youth & Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shoreview, MN
  • NPI 1639275852
  Medicare reassignment NPD
• Northeast Youth & Family Services

  • Community Health Clinic/Center
  • White Bear Lake, MN
  • NPI 1073098810
  NPD (past)

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1881334712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 LEXINGTON AVE N STE 205",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268044",
            "telephone_number": "651-486-3808",
            "fax_number": "651-486-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 LEXINGTON AVE N STE 205",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268044",
            "telephone_number": "651-486-3808",
            "fax_number": "651-486-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "EMILY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.