Nancy Avila, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20140 Issued in MN

Practice address

6900 78TH Ave N
Brooklyn Park, MN 55445-2719

Phone

(763) 569-2638

Fax

(612) 728-2095

NPI assigned

Jun 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

3C HansonsGroup PAC ID 1850795113, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• 3C Hansons

  • Mental Health Counselor
  • Richfield, MN
  • NPI 1780221887
  Medicare reassignment Care Compare group NPD
• Planned Parenthood Minnesota, North Dakota, South Dakota

  • Non-Surgical Family Planning Clinic/Center
  • Saint Paul, MN
  • NPI 1629057146
  NPD

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1982055778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 78TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452719",
            "telephone_number": "763-569-2638",
            "fax_number": "612-728-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 78TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452719",
            "telephone_number": "763-569-2638",
            "fax_number": "612-728-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "NANCY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serina Aubrecht, NMD
• Audrie Home Health Care LLC.
• Kasey Nicole Aune, M.ED.
• Aurora Recovery Center LLC
• Avid Home and Community Healthcare Services LLC
• Aware Health Services LLC
• Ayodele Awoleye
• Fouad George Azzam, M.D.
• B D Edwards and Co.,LLC
• B P Chiropractic Clinic

• Clinical Social Worker in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.