GLENNA COLERIDER-KRUGH (LICSW) – Clinical Social Worker, NPI 1033862651

GLENNA COLERIDER-KRUGH (LICSW) is a healthcare provider. based in Minneapolis, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 29551 (MN). The NPI Number for GLENNA COLERIDER-KRUGH (LICSW) is 1033862651

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
GLENNA COLERIDER-KRUGH (LICSW)
NPI
1033862651
Phone
(889) 861-2223
Address
310 CLIFTON AVE
Enumeration Date
2 February 2022
Last Update Date
13 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122238898
Graduation Year
2020 (6 years ago)
PAC ID
8729437660
Group Practice PAC ID
7517181266
Professional Enrollment ID
I20231218001396
Address ID
MN554033218MI310XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for GLENNA COLERIDER-KRUGH (LICSW)

  • 310 CLIFTON AVE

    MINNEAPOLIS, MN 554033218

    Phone: (889) 861-2223

    Type: Location

  • 2020 GARFIELD AVE APT 2

    MINNEAPOLIS, MN 554053211

    Phone: (626) 676-5080

    Type: Mailing

  • 5329 CHICAGO AVE

    MINNEAPOLIS, MN 554171733

    Phone: (626) 676-5080

    Type: Mailing

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: 2023-12-18

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
I20231218001396IClinical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55403)

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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: 7517181266View full group profile
NameSpecialtyState
Clinical PsychologistMN
Clinical PsychologistMN
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Mental Health CounselorMN
-MN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What unique ID ties claims to GLENNA COLERIDER-KRUGH (LICSW)?
NPI 1033862651 is assigned to GLENNA COLERIDER-KRUGH (LICSW) under the national enumeration system.
Does this profile mean GLENNA COLERIDER-KRUGH (LICSW) is currently active?
Yes — GLENNA COLERIDER-KRUGH (LICSW) appears active in the national provider directory.
Does GLENNA COLERIDER-KRUGH (LICSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for GLENNA COLERIDER-KRUGH (LICSW). Clinical services aligned with this taxonomy classification.
Where does public data place GLENNA COLERIDER-KRUGH (LICSW)?
The snapshot lists Minneapolis, Minnesota for GLENNA COLERIDER-KRUGH (LICSW); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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