AUTUMN MICHELLE PHENOW (NPI# 1154980068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154980068 |
| Entity Type | Individual |
| Full Name | AUTUMN MICHELLE PHENOW |
| Credential | MSW, LICSW |
| Practice Address |
6341 University Ave Ne Fridley MN 55432-4946 |
| Mailing Address |
2785 White Bear Ave N Ste 403 Maplewood MN 55109-1327 |
| Practice Telephone | 6126726999 |
| Mailing Telephone | 6513955775 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
22651 | MN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3450 Oleary Ln, Eagan, MN 551232340 | 6513630114 |
| Street Address |
6341 UNIVERSITY AVE NE |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-4946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912968546 | Barbara Anne Bank | Family Medicine | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2006-03-31 |
| 1649764069 | Joni Lager | Health Educator | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2018-06-19 |
| 1467978213 | Jaclyn Rust | Pharmacist | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2017-08-14 |
| 1053841569 | Steven Alex Rizzi | Optometrist | 6341 University Ave Ne, Fridley, MN 55432 | 2017-06-16 |
| 1639613318 | Fairview Health Services | Counselor | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2016-12-14 |
| 1497162721 | Laura Lorraine Hilker | Nurse Practitioner | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2014-07-18 |
| 1861838971 | Lois Finney | Dietitian, Registered | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2013-05-15 |
| 1831443480 | Andrew Allan Link | Physician Assistant | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2012-11-05 |
| 1962769125 | Michael Brian Macintire | Family Medicine | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2012-04-12 |
| 1457649667 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2011-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457786998 | Mark Henderson Davis | Social Worker | 5384 Street Ne, Community Options Fridley, Fridley, MN 55421 | 2013-09-03 |
| 1932470127 | Catherine Rose Johanneck | Social Worker | 7362 University Ave Ne Ste 101, Fridley, MN 55432-3152 | 2012-01-19 |
| 1205099215 | Candice Kae Mohammad | Social Worker | 490 Fairmont St Ne, No Business, Fridley, MN 55432-1667 | 2008-07-09 |
| 1063528818 | Jodie Rae Holzman | Social Worker | 1026 64th Ave Ne, Fridley, MN 55432-5138 | 2006-08-22 |
| 1679516611 | Deanne Miller | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2006-06-14 |
| 1083226112 | Erin Kristine Church | Social Worker | 500 Osborne Rd Ne Ste 255, Fridley, MN 55432-2768 | 2020-08-19 |
| 1881237063 | Jennifer Lawrence | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-10-21 |
| 1568004323 | Moriah Mueller | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-10-14 |
| 1275194391 | Krysta Victoria Palmer | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-06-28 |
| 1548722200 | Krystal Vollmuth | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-04-02 |
| Find all providers in FRIDLEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.