Active NPI
James Edwin Chadwick, MSW, LICSW
- Clinical Social Worker
- Saint Paul, MN
National Provider Identifier
1922549252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 24771
- Practice address
- 595 Selby Ave
Saint Paul, MN 55102-1730 - Phone
- (612) 723-3796
- NPI assigned
- Mar 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 24771 | MN | Primary |
Addresses
Primary practice location
595 Selby Ave
Saint Paul, MN 55102-1730
Mailing address
2446 Aldrich Ave S Apt 302
Minneapolis, MN 55405-2955
Phone (612) 723-3796
Other practice location 1
2920 Bryant Ave S
Minneapolis, MN 55408-2195
Phone (612) 723-3796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 26, 2023 through Dec 26, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24771 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amethyst Wellness, Inc. | Clinical | Current | 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": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1922549252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2446 ALDRICH AVE S APT 302",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554052955",
"telephone_number": "612-723-3796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 SELBY AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551021730",
"telephone_number": "612-723-3796"
}
],
"practiceLocations": [
{
"address_1": "2920 Bryant Ave S",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554082195",
"country_code": "US",
"telephone_number": "612-723-3796",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHADWICK",
"first_name": "JAMES",
"middle_name": "EDWIN",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "24771",
"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 Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.