Cyndie Deridder, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16288 Issued in MN

Practice address

19021 Freeport St NW
Suite 400
Elk River, MN 55330-1278

Phone

(763) 633-3800

Fax

(763) 633-3808

NPI assigned

Mar 18, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Accurate Home Care, LLC

  • Home Health Agency
  • Otsego, MN
  • NPI 1689723207
  NPD (past)
• Midwest Center for Personal & Family Development PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1285730903
  NPD (past)

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1992047914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19021 FREEPORT ST NW",
            "address_2": "SUITE 400",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301278",
            "telephone_number": "763-633-3800",
            "fax_number": "763-633-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19021 FREEPORT ST NW",
            "address_2": "SUITE 400",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301278",
            "telephone_number": "763-633-3800",
            "fax_number": "763-633-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIDDER",
        "first_name": "CYNDIE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Michael Damiani
• DBT and Emdr Specialists, P.a.
• Gabriel Robert Dean, PHARM D
• Angela K Dee-Ellingson, PT
• Dekals Home Care
• Thomas Dewall, D.C.
• Direct Home Care Services LLC
• Directcare Chiropractic, PA
• Ronda Marie Disch
• Divine Life LLC

• Clinical Social Worker in Elk River, MN
• Providers in Elk River, 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 Mar 18, 2013; 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.