Individual provider Active NPI

Terri Flansburg, LICSW

  • Clinical Social Worker
  • St Louis Park, MN
National Provider Identifier
1942732813
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22747 Issued in MN
Practice address
6726 Walker St
St Louis Park, MN 55426-4615
Phone
(612) 361-0053
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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 22747 MN Primary

Addresses

Primary practice location

6726 Walker St
St Louis Park, MN 55426-4615

Mailing address

1620 Rhode Island Ave N
Golden Valley, MN 55427-4065
Phone (612) 203-3989

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
I20220212000161 MN Practitioner - Clinical Psychologist 2567855604 Practice locations: Golden Valley, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1620 Rhode Island Ave N
Golden Valley, MN 55427-4065
Phone (612) 361-0053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22747MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mill City Mental Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

919 Lilac Dr N
Minneapolis, MN 55422

6726 Walker St
St Louis Park, MN 55426
Phone (612) 361-0053

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1942732813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 RHODE ISLAND AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274065",
            "telephone_number": "612-203-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6726 WALKER ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264615",
            "telephone_number": "612-361-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANSBURG",
        "first_name": "TERRI",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.