JEFFREY OLDS (LICSW) – Clinical Social Worker, NPI 1699962324

JEFFREY OLDS (LICSW) is a healthcare provider. based in Grand rapids, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. The NPI Number for JEFFREY OLDS (LICSW) is 1699962324

Main info

Male
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY OLDS (LICSW)
NPI
1699962324
Phone
(218) 327-4886
Address
35382 US HIGHWAY 2
Enumeration Date
26 September 2007
Last Update Date
6 June 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2183263401
Graduation Year
2003 (23 years ago)
PAC ID
0840595559
Group Practice PAC ID
8123939550
Professional Enrollment ID
I20160217002419
Address ID
MN557448648GR1601XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:18State licenses:0Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for JEFFREY OLDS (LICSW)

  • 35382 US HIGHWAY 2

    GRAND RAPIDS, MN 557444754

    Phone: (218) 327-4886

    Type: Location

  • 1200, South Pokegama Avenue, Grand Rapids, Itasca County, Minnesota, 55744, United States

    STE 160

    GRAND RAPIDS, MN 557444296

    Phone: (218) 327-8937

    Fax: (218) 327-0348

    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: 2016-02-17

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
I20160217002419IClinical 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 minutes7818$0
90791Psychiatric diagnostic evaluation1111$0
View full utilization report →

Insurance plans in this area (ZIP 55744)

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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: 8123939550View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Nurse PractitionerMN
Nurse PractitionerMN
-MN
General SurgeryMN
Family PracticeMN
Nurse PractitionerMN
-MN
Family PracticeMN
Diagnostic RadiologyMN

Reviews

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Frequently asked questions

How do I look up JEFFREY OLDS (LICSW) by NPI?
Use NPI 1699962324 when you need to reference JEFFREY OLDS (LICSW) in forms, claims, or directories.
Is JEFFREY OLDS (LICSW) active in the national directory?
JEFFREY OLDS (LICSW)'s public NPI profile is in an active state.
Does JEFFREY OLDS (LICSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for JEFFREY OLDS (LICSW). Clinical services aligned with this taxonomy classification.
Where does public data place JEFFREY OLDS (LICSW)?
The snapshot lists Grand Rapids, Minnesota for JEFFREY OLDS (LICSW); download NPPES for the complete set.
What if Grand Rapids, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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