Janice G Carr-Herseth, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

9295 Issued in MN

Practice address

715 Delmore Dr
Roseau, MN 56751-1534

Phone

(218) 463-2500

Fax

(218) 463-4782

NPI assigned

May 3, 2007

Last updated

Jan 15, 2019By 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 2

Addresses

Other identifiers 1

Other names 1

• Janice G Carr Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1881816353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511534",
            "telephone_number": "218-463-2500",
            "fax_number": "218-463-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511534",
            "telephone_number": "218-463-2500",
            "fax_number": "218-463-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR-HERSETH",
        "first_name": "JANICE",
        "middle_name": "G",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "9295",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "9295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497472700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "CARR",
            "middle_name": "G",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bio-Medical Applications of Minnesota, Inc. (Fresenius Kidney Care Roseau)
• Sarah Blakeslee, MOTR/L
• David A Brett, D.O.
• Sara B Broten, PHARMD
• Vangievail Jean Byfuglien
• Center Street Dental Professionals, P.a.
• Kayla Dahl
• Shivali Devgon, MD
• Annabi I Djalo, MD
• Cynthia Faye Drost-Sandy, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.