CONNIE J GIBSON (MSSW LICSW) – Social Worker, NPI 1386778918

CONNIE J GIBSON (MSSW LICSW) is a healthcare provider. based in Waconia, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSSW LICSW. They hold a License No. LICSW4945 (MN). The NPI Number for CONNIE J GIBSON (MSSW LICSW) is 1386778918

Main info

Female
39 Years Of Experience
Accepts Medicare Assignment
Name
CONNIE J GIBSON (MSSW LICSW)
NPI
1386778918
Phone
(952) 442-4437
Address
540 E 1ST ST
Enumeration Date
15 March 2007
Last Update Date
19 February 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9524424437
Graduation Year
1987 (39 years ago)
PAC ID
8921272600
Group Practice PAC ID
8527041961
Professional Enrollment ID
I20111115000106
Address ID
MN553871601WA540XXSTXX400
Telehealth
Yes
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 CONNIE J GIBSON (MSSW LICSW)

  • 540 E 1ST ST

    WACONIA, MN 553871600

    Phone: (952) 442-4437

    Fax: (952) 442-3084

    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: 2011-11-15

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
I20111115000106IClinical 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
90834Psychotherapy, 45 minutes15616$0
View full utilization report →

Insurance plans in this area (ZIP 55387)

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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: 8527041961View full group profile

Reviews

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Frequently asked questions

What is the standard ID for CONNIE J GIBSON (MSSW LICSW) in the U.S.?
In the U.S., CONNIE J GIBSON (MSSW LICSW) is identified by NPI 1386778918.
Does the public listing show CONNIE J GIBSON (MSSW LICSW) as active?
CONNIE J GIBSON (MSSW LICSW)'s NPI record reflects an active status in NPPES.
How should patients interpret CONNIE J GIBSON (MSSW LICSW)'s specialty?
The extract shows Social Worker for CONNIE J GIBSON (MSSW LICSW). Clinical services aligned with this taxonomy classification.
Can patients visit CONNIE J GIBSON (MSSW LICSW) in Waconia, Minnesota?
For routing, start with Waconia, Minnesota for CONNIE J GIBSON (MSSW LICSW), then verify phone and hours locally.
Why is information missing for CONNIE J GIBSON (MSSW LICSW)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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