Individual provider Active NPI

Michelle E Jones, MSW, LICSW, LADC

  • Clinical Social Worker
  • St Louis Park, MN
National Provider Identifier
1962850065
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20483 Issued in MN
Practice address
4027 County Road 25
St Louis Park, MN 55416
Phone
(612) 925-6033
Fax
(612) 925-8496
NPI assigned
May 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303230 MN
Clinical Social Worker 1041C0700X 20483 MN Primary

Addresses

Primary practice location

4027 County Road 25
St Louis Park, MN 55416

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-2000

Other practice location 2

6200 Shingle Creek Pkwy Ste 350
Brooklyn Center, MN 55430-2155
Phone (763) 503-8560

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
I20160829000126 MN Practitioner - Clinical Social Worker 4284929316 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303230MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2020 Accepting new patients
Fairview Health Services CurrentSince May 8, 2020 Accepting new patients
Associated Clinic of Psychology Inc CurrentSince Oct 16, 2017 Accepting new patients
Fairview Health Services Current Accepting new patients
Shoreview Mental Health Center, LLC CurrentSince Sep 15, 2017 Accepting new patients
Fairview Express Care CurrentSince May 8, 2020 Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

6200 Shingle Creek Pkwy
Ste 350
Brooklyn Center, MN 55430
Phone (763) 503-8560

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

2450 Riverside Ave
Ste F140
Minneapolis, MN 55454
Phone (651) 464-4847

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

5985 Rice Creek Pkwy
Ste 201
Shoreview, MN 55126
Phone (651) 348-7240

4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033

4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033

Organizations & group practices 9

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": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1962850065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 COUNTY ROAD 25",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "763-520-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6200 Shingle Creek Pkwy Ste 350",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Center",
            "state": "MN",
            "postal_code": "554302155",
            "country_code": "US",
            "telephone_number": "763-503-8560",
            "fax_number": "763-503-8563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "credential": "MSW, LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303230",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.