CASANDRA KAY ANDERSON (LICSW) – Clinical Social Worker, NPI 1164107660

CASANDRA KAY ANDERSON (LICSW) is a healthcare provider. based in Crookston, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 29633 (MN). The NPI Number for CASANDRA KAY ANDERSON (LICSW) is 1164107660

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
CASANDRA KAY ANDERSON (LICSW)
NPI
1164107660
Phone
(218) 281-3940
Address
603 BRUCE ST
Enumeration Date
21 June 2023
Last Update Date
21 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2182813940
Graduation Year
2023 (3 years ago)
PAC ID
4385003508
Group Practice PAC ID
6709787609
Professional Enrollment ID
I20230706003001
Address ID
MN567162914CR603XXSTXX300

Contacts

Main Contact
CredibleBH.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Other namesUpdated within 12 months

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for CASANDRA KAY ANDERSON (LICSW)

  • 603 BRUCE ST

    CROOKSTON, MN 567162914

    Phone: (218) 281-3940

    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: 2023-07-06

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
I20230706003001IClinical 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 56716)

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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: 6709787609View full group profile
NameSpecialtyState
Addiction MedicineFL
-MN
Clinical Social WorkerMN
Clinical Social WorkerKY
Mental Health CounselorMN
Nurse PractitionerND
Mental Health CounselorMN
Psychiatry, NeurologyMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What number should I use to identify CASANDRA KAY ANDERSON (LICSW) for billing?
Administrative and clinical systems typically use NPI 1164107660 for CASANDRA KAY ANDERSON (LICSW).
Is CASANDRA KAY ANDERSON (LICSW) currently accepting referrals based on NPI status?
Registry metadata lists CASANDRA KAY ANDERSON (LICSW) as active.
Which specialty label fits CASANDRA KAY ANDERSON (LICSW)?
NPPES ties CASANDRA KAY ANDERSON (LICSW) to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is CASANDRA KAY ANDERSON (LICSW) tied to Crookston, Minnesota?
If you are local to Crookston, Minnesota, CASANDRA KAY ANDERSON (LICSW) may be relevant to your search.
Who maintains CASANDRA KAY ANDERSON (LICSW)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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