Individual provider Active NPI

Rebecca Alla Orrick Magnuson, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1922663236
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW Issued in MN
Practice address
2021 E Hennepin Ave Ste 330
Minneapolis, MN 55413-1798
Phone
(612) 435-7234
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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 LICSW MN Primary

Addresses

Primary practice location

2021 E Hennepin Ave Ste 330
Minneapolis, MN 55413-1798

Mailing address

2021 E Hennepin Ave Ste 330
Minneapolis, MN 55413-1798
Phone (612) 435-7234

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
LICSWMNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1922663236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 E HENNEPIN AVE STE 330",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131798",
            "telephone_number": "612-435-7234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E HENNEPIN AVE STE 330",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131798",
            "telephone_number": "612-435-7234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNUSON",
        "first_name": "REBECCA",
        "middle_name": "ALLA ORRICK",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "LICSW",
            "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 May 2, 2019; 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.