Individual provider Active NPI

Jessica E Bedford, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1881917565
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17468 Issued in MN
Practice address
1121 E 46TH St
Minneapolis, MN 55407-3562
Phone
(763) 227-6010
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17468 MN Primary

Addresses

Primary practice location

1121 E 46TH St
Minneapolis, MN 55407-3562

Mailing address

1121 E 46TH St
Minneapolis, MN 55407-3562
Phone (763) 227-6010

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17468MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1881917565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E 46TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073562",
            "telephone_number": "763-227-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E 46TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073562",
            "telephone_number": "763-227-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDFORD",
        "first_name": "JESSICA",
        "middle_name": "E",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.