Colette Rose Neron Ellenbecker, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10224 Issued in MN

Practice address

3701 12TH St N
Suite 203
Saint Cloud, MN 56303-2255

Phone

(218) 631-5993

Fax

(218) 631-7043

NPI assigned

May 21, 2012

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Family Support Services IncGroup PAC ID 0244297448, 10 clinicians

Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  Medicare reassignment Care Compare group NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1912267287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N",
            "address_2": "SUITE 203",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032255",
            "telephone_number": "218-631-5993",
            "fax_number": "218-631-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERON ELLENBECKER",
        "first_name": "COLETTE",
        "middle_name": "ROSE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Nelson
• Nemeth Orthodontics
• Benjamin Nemeth, DDS
• Robert B. Nemeth, DDS
• Rebecca Nerestant
• Taryn Denise Nesbit
• Chelsey Lynn Ness, FNP-C
• Taryn Lee Neubauer, PHARM.D.
• Gayle Linda Neuerburg, MS, LMFT
• Catherine Neuman, CNP

• Clinical Social Worker in Saint Cloud, MN
• Providers in Saint Cloud, 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 20, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.