Dimitriy B Zelikman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21621 Issued in MN

Practice address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533

Phone

(612) 636-9268

NPI assigned

Sep 19, 2017

Sex

Male

Sole proprietor

No

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.

• Good Life Mental Halth Services LLC

  • Adult Mental Health Clinic/Center
  • Dayton, MN
  • NPI 1104595586
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2017.

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1982123105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-636-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-636-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELIKMAN",
        "first_name": "DIMITRIY",
        "middle_name": "B",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "68262",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alvin Zeighami-Dominguez
• Kidmealem Lulseged Zekarias, M.D.
• Najma Nuredin Zekeria
• Robert James Zeleznikar, MD
• Brian David Zelickson, M.D.
• Jeremy Zellmann
• Seble Zemariyam
• Sarah Zemek, DPT
• Morgan Zender
• Aster Zenebe, MSW, LGSW

• All providers in Minneapolis, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.