CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) – Clinical Social Worker, NPI 1932470127

CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) is a healthcare provider. based in Fridley, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials M.S.W. L.I.C.S.W. They hold a License No. 17989 (MN). The NPI Number for CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) is 1932470127

Main info

Female
17 Years Of Experience
Name
CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W)
NPI
1932470127
Phone
(763) 503-3981
Address
7362 UNIVERSITY AVE NE STE 101
Enumeration Date
19 January 2012
Last Update Date
3 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635033981101
Graduation Year
2009 (17 years ago)
PAC ID
1052571155
Group Practice PAC ID
6800889577
Professional Enrollment ID
I20120328000069
Address ID
MN554323152FR7362XNEXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W)

  • 7362 UNIVERSITY AVE NE STE 101

    FRIDLEY, MN 554323152

    Phone: (763) 503-3981

    Fax: (763) 503-3981

    Type: Mailing

  • 315 N Cedar Ave

    Owatonna, MN 550602307

    Phone: (507) 451-3282

    Fax: (507) 451-3287

    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: 2012-03-28

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
I20120328000069IClinical 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 55432)

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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: 6800889577View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What is CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W)'s NPI number?
CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W)'s NPI is 1932470127 — the number used across U.S. healthcare to identify this provider.
Is CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) shown as active in public data?
Registry records indicate CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) maintains an active NPI.
What clinical focus is listed for CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W)?
At a glance, CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) located near Fridley?
CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) currently maps to Fridley, Minnesota in this extract.
When was this NPI issued?
Enumeration for CATHERINE ROSE JOHANNECK (M.S.W. L.I.C.S.W) is noted as January 19, 2012 where the registry provides it.

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