Individual provider Active NPI

Bridget Marie Forst, LICSW

  • Clinical Social Worker
  • Breckenridge, MN
National Provider Identifier
1942914825
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
115 5TH St N
Breckenridge, MN 56520-1420
Phone
(218) 643-9330
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 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 Primary

Addresses

Primary practice location

115 5TH St N
Breckenridge, MN 56520-1420

Mailing address

2004 300TH St
Breckenridge, MN 56520-9607
Phone (507) 766-3694

Other names 1

  • Bridget Marie Forst Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL http://birchwoodcounseling.com/ Direct

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
I20240920003510 MN Practitioner - Clinical Social Worker 6305387085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Ohio State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solutions Counseling Services IncGroup PAC ID 7416289277, 8 clinicians

Practice addresses (Care Compare)

115 5TH St N
Breckenridge, MN 56520-1434
Phone (218) 643-9330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Counseling Services, Inc. Clinical CurrentSince Aug 4, 2024 Accepting new patients

Locations

115 5th St N
Breckenridge, MN 56520
Phone (218) 643-9330

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": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1942914825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 300TH ST",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565209607",
            "telephone_number": "507-766-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 5TH ST N",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201420",
            "telephone_number": "218-643-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORST",
        "first_name": "BRIDGET",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://birchwoodcounseling.com/",
            "affiliation": "N",
            "endpointDescription": "Online Website/Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "115 5th St N",
            "city": "Breckenridge",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565201420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "FORST",
            "middle_name": "MARIE",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Breckenridge, MN

Sources for this page

Verify at the official NPI Registry.