Individual provider Active NPI

Nimo Ali,, MSW, LICSW

  • Clinical Social Worker
  • Apple Valley, MN
National Provider Identifier
1922700657
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28905 Issued in MN
Practice address
15322 Galaxie Ave Ste 203C
Apple Valley, MN 55124-3152
Phone
(612) 458-5083
Fax
(612) 354-8387
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 28905 MN Primary

Addresses

Primary practice location

15322 Galaxie Ave Ste 203C
Apple Valley, MN 55124-3152

Mailing address

4470 W 78TH Street Cir Ste 200
Bloomington, MN 55435-5419
Phone (612) 458-5083

Other practice location 1

525 Portland Ave
Minneapolis, MN 55415-1533
Phone (612) 596-1223

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230710002358 MN Practitioner - Clinical Social Worker 6800255738 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28905MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Behavioral Solutions, LLC Clinical CurrentSince Oct 1, 2024 Accepting new patients
Fairview Express Care CurrentSince Apr 24, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Apr 24, 2023 Accepting new patients

Locations

15322 Galaxie Ave
Ste 203C
Apple Valley, MN 55124
Phone (612) 458-5083

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

7635 148th St W
Saint Paul, MN 55124
Phone (651) 308-9147

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

2700 Snelling Ave N
Ste 400
Saint Paul, MN 55113
Phone (651) 697-5804

2 2nd Ave S
Ste 35
Sauk Rapids, MN 56379
Phone (612) 483-4153

Organizations & group practices 4

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1922700657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 W 78TH STREET CIR STE 200",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355419",
            "telephone_number": "612-458-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15322 GALAXIE AVE STE 203C",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551243152",
            "telephone_number": "612-458-5083",
            "fax_number": "612-354-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151533",
            "country_code": "US",
            "telephone_number": "612-596-1223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI,",
        "first_name": "NIMO",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.