Individual provider Active NPI

Christina Harrison

  • Clinical Social Worker
  • Andover, MN
National Provider Identifier
1962908160
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24395 Issued in MN
Practice address
1875 Station Pkwy NW
Andover, MN 55304-3319
Phone
(763) 520-6520
NPI assigned
Apr 5, 2018
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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 24395 MN Primary

Addresses

Primary practice location

1875 Station Pkwy NW
Andover, MN 55304-3319

Mailing address

1875 Station Pkwy NW
Andover, MN 55304-3319

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-0000

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
I20180824002380 MN Practitioner - Clinical Social Worker 7416206339 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16 Atlantic Ave
Lynbrook, NY 11563-3046

1875 Station Pkwy NW
Andover, MN 55304-3319

871 Jefferson Ave
Saint Paul, MN 55102-2506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rum River Counseling, Inc. Clinical CurrentSince Aug 9, 2023 Accepting new patients
Emily Program P C CurrentSince Jul 9, 2018 Accepting new patients
North Memorial Health Care CurrentSince Jan 1, 2021 Accepting new patients
North Memorial Health Care CurrentSince Jan 1, 2021 Accepting new patients

Locations

1875 Station Pkwy NW
Andover, MN 55304

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

7200 Hudson Blvd N
Ste 220
Oakdale, MN 55128

18205 45th Ave N
Ste D
Plymouth, MN 55446
Phone (214) 554-4089

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

3366 Oakdale Ave N
Ste 315
Robbinsdale, MN 55422
Phone (763) 520-7900

1619 Dayton Ave
Ste 201
Saint Paul, MN 55104
Phone (651) 645-5504

2265 Como Ave
Saint Paul, MN 55108

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1962908160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 STATION PKWY NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043319",
            "telephone_number": "763-520-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "763-581-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.