Michelle Marie Dick, LICSW – Clinical Social Worker

Key facts

NPI: 1922568641
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 17229 (MN)
Practice address: 100 Freeman Dr
Saint Peter, MN 56082-3504
Phone: (507) 985-2190
Fax: (651) 431-7676
NPI assigned: Mar 20, 2019
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

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.

Horizon Homes, Inc Mental Illness Community Based Residential Treatment Facility · Mankato, MN · NPI 1093895997

NPD (past)
Horizon Homes, Inc. Mental Illness Community Based Residential Treatment Facility · Mankato, MN · NPI 1124333810

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
17229	MN	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Horizon Homes, Inc		Past since Jun 26, 2022	Accepting new patients
Horizon Homes, Inc.		Past since Jun 26, 2022	Accepting new patients

Interoperability endpoints

FHIR API: https://api.qualifacts.org/api/fhir/horizonhomes/r4/

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	17229	MN	Yes

Addresses

Primary practice location

100 Freeman Dr
Saint Peter, MN 56082-3504

Mailing address

100 Freeman Dr
Saint Peter, MN 56082-3504
Phone (507) 985-2190

Other practice location 1

825 S Front St
Mankato, MN 56001-2402
Phone (507) 344-3360

Other providers in Saint Peter, MN

Emma Davis
Lula Ahmed Dayib
Kristin Lee Dehrkoop
Sheryl Lynn Delain-Adderley, PHD, LP
Nicholas Devetter, DO
Lauren Renaye Lefavor Dickie, PSYD LP
Direct Care and Treatment - Forensic Services
Blake Thomas Dirks, OD
Zachary Blake Dirks, O.D.
Makenna Douglas, PSY.D., LP

All providers in Saint Peter, MN · Clinical Social Worker in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.