JESSICA RAE CROATT NIEMI (LICSW) – Clinical Social Worker, NPI 1265653653

JESSICA RAE CROATT NIEMI (LICSW) is a healthcare provider. based in Park rapids, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 15124 (MN). The NPI Number for JESSICA RAE CROATT NIEMI (LICSW) is 1265653653

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA RAE CROATT NIEMI (LICSW)
NPI
1265653653
Phone
(218) 366-9229
Address
515 BRIDGE ST
Enumeration Date
1 May 2007
Last Update Date
16 June 2018

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
2183669229
Graduation Year
2000 (26 years ago)
PAC ID
9436419421
Group Practice PAC ID
3779610472
Professional Enrollment ID
I20180213001337
Address ID
MN564701210PA515XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for JESSICA RAE CROATT NIEMI (LICSW)

  • 515 BRIDGE ST

    PARK RAPIDS, MN 564701210

    Phone: (218) 366-9229

    Fax: (218) 237-2520

    Type: Mailing

  • 1426 BEMIDJI AVE N STE 1

    BEMIDJI, MN 566013882

    Phone: (218) 444-2233

    Fax: (218) 237-2520

    Type: Location

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: 2018-02-13

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
I20180213001337IClinical 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 56470)

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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: 3779610472View full group profile
NameSpecialtyState
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
-MN
Clinical Social WorkerMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Can I use this page to confirm JESSICA RAE CROATT NIEMI (LICSW)'s NPI?
Yes. JESSICA RAE CROATT NIEMI (LICSW) is listed with NPI 1265653653 in the public NPI dataset.
Is JESSICA RAE CROATT NIEMI (LICSW) still practicing?
JESSICA RAE CROATT NIEMI (LICSW) is currently listed as active in the public NPI registry.
What taxonomy line describes JESSICA RAE CROATT NIEMI (LICSW)?
For research purposes, treat JESSICA RAE CROATT NIEMI (LICSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for JESSICA RAE CROATT NIEMI (LICSW)?
JESSICA RAE CROATT NIEMI (LICSW)'s geographic hint is Park Rapids, Minnesota in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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