ALICIA ANN VANDENBERG (MSW, LICSW) – Clinical Social Worker, NPI 1023410107

ALICIA ANN VANDENBERG (MSW, LICSW) is a healthcare provider. based in Maplewood, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 15924 (MN). The NPI Number for ALICIA ANN VANDENBERG (MSW, LICSW) is 1023410107

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
ALICIA ANN VANDENBERG (MSW, LICSW)
NPI
1023410107
Phone
(651) 254-4793
Address
2345 ARIEL ST N
Enumeration Date
21 September 2014
Last Update Date
21 September 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512574159
Graduation Year
2002 (24 years ago)
PAC ID
8628299088
Group Practice PAC ID
3173983038
Professional Enrollment ID
I20141028001835
Address ID
MN550259788FO18323NXXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for ALICIA ANN VANDENBERG (MSW, LICSW)

  • 2345 ARIEL ST N

    MAPLEWOOD, MN 551092248

    Phone: (651) 254-4793

    Fax: (651) 254-0877

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-10-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141028001835IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour10414$0
90834Psychotherapy, 45 minutes5814$0
View full utilization report →

Insurance plans in this area (ZIP 55109)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173983038View full group profile
NameSpecialtyState
Mental Health CounselorMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What federal number belongs to ALICIA ANN VANDENBERG (MSW, LICSW)?
The federal identifier for ALICIA ANN VANDENBERG (MSW, LICSW) is NPI 1023410107.
Does this profile mean ALICIA ANN VANDENBERG (MSW, LICSW) is currently active?
Yes — ALICIA ANN VANDENBERG (MSW, LICSW) appears active in the national provider directory.
What field does ALICIA ANN VANDENBERG (MSW, LICSW) work in?
You can think of ALICIA ANN VANDENBERG (MSW, LICSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for ALICIA ANN VANDENBERG (MSW, LICSW)?
The page summarizes Maplewood, Minnesota for ALICIA ANN VANDENBERG (MSW, LICSW); expand the address list for detail.
Is ALICIA ANN VANDENBERG (MSW, LICSW) a real provider?
This page reflects official NPPES data for NPI 1023410107. Always confirm identity and privileges with the practice and licensing boards.

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