Individual provider Active NPI

Susan Amann, MSW, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1912434309
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22645 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101
Phone
(651) 254-4816
NPI assigned
May 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2018

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 22645 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101

Mailing address

517 10TH St N
Hudson, WI 54016-1101
Phone (715) 222-9791

Other practice location 1

516 Mission House Ln
New Brighton, MN 55112-2571
Phone (651) 636-5120

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22645MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Ministry Development Center, Inc. Clinical PastSince Jan 22, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1912434309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 10TH ST N",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161101",
            "telephone_number": "715-222-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-4816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Mission House Ln",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "551122571",
            "country_code": "US",
            "telephone_number": "651-636-5120",
            "fax_number": "651-636-5124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMANN",
        "first_name": "SUSAN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.