DONNA ANDERSON (LICSW) – Clinical Social Worker, NPI 1669491908

DONNA ANDERSON (LICSW) is a healthcare provider. based in Roseville, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 1288 (MN). The NPI Number for DONNA ANDERSON (LICSW) is 1669491908

Main info

Female
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
DONNA ANDERSON (LICSW)
NPI
1669491908
Phone
(651) 621-2495
Address
1711 COUNTY ROAD B W
Enumeration Date
18 July 2006
Last Update Date
8 November 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6516212495
Graduation Year
1976 (50 years ago)
PAC ID
9234328790
Professional Enrollment ID
I20110113001183
Address ID
MN551134069RO1711XWXXX501
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

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Provider Addresses for DONNA ANDERSON (LICSW)

  • 1711, County Road B West, Roseville, Ramsey County, Minnesota, 55113, United States

    ROSEWOOD OFFICE PLAZA SUITE 210S

    ROSEVILLE, MN 551134057

    Phone: (651) 621-2495

    Fax: (651) 621-2496

    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: 2011-01-13

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
I20110113001183IClinical 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 hour17517$0
View full utilization report →

Insurance plans in this area (ZIP 55113)

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Reviews

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Frequently asked questions

How do payers reference DONNA ANDERSON (LICSW)?
For DONNA ANDERSON (LICSW), use NPI 1669491908 as the unique 10-digit identifier.
Would DONNA ANDERSON (LICSW) appear as active to a payer?
You can treat DONNA ANDERSON (LICSW) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is DONNA ANDERSON (LICSW)?
DONNA ANDERSON (LICSW) is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for DONNA ANDERSON (LICSW)?
Travel planning: use Roseville, Minnesota as the reference point for DONNA ANDERSON (LICSW), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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