ANDREA MAY LUCCA (NPI# 1386142818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386142818 |
| Entity Type | Individual |
| Full Name | ANDREA MAY LUCCA |
| Credential | LICSW |
| Practice Address |
1300 Anne St Nw Bemidji MN 56601-5103 |
| Mailing Address |
Po Box 2010 Fargo ND 58122-2484 |
| Practice Telephone | 2183335000 |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
21614 | MN | Behavioral Health & Social Service Providers |
| Street Address |
1300 ANNE ST NW |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922090901 | Marvin R Fetter | Orthopaedic Surgery | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2005-08-17 |
| 1679129555 | Ashley Marie Wavrin | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-08-15 |
| 1649824996 | Angela Halvorson | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-25 |
| 1114589348 | Rachel Marie Vesta | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-09 |
| 1407419419 | Ethan Axtman | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-04-16 |
| 1053895201 | Jarad Syrstad | Physical Therapist | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-23 |
| 1851874416 | Kimberly Miller | Physician Assistant | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-10 |
| 1780175752 | Billie Jo Dressing | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-05-24 |
| 1356859979 | Andrew William Rook | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-17 |
| 1891214466 | Kelley Brooke Olsen | Nurse Anesthetist, Certified Registered | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2017-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| 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 |
|---|---|---|---|---|
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1588803274 | Jodi Anderson | Social Worker | 819 Paul Bunyan Drive S, Bemidji, MN 56601 | 2009-02-19 |
| 1265653653 | Jessica Rae Croatt Niemi | Social Worker | 1426 Bemidji Ave N Ste 1, Bemidji, MN 56601-3882 | 2007-05-01 |
| 1124143813 | Sarah H. Diehl | Social Worker | 3835 Supreme Ct. Nw, Suite 6, Bemidji, MN 56601-4405 | 2007-03-20 |
| 1326139114 | Donald Ray Turk | Social Worker | 722 15th Street, Bemidji, MN 56601 | 2006-09-27 |
| 1154422012 | Kimberly Jean Sletta Avenson | Social Worker | 722 15th Street N.w., Bemidji, MN 56619-0640 | 2006-09-25 |
| 1255431003 | Thomas Eugene Williams | Social Worker | 722 15th St Nw, Bemidji, MN 56601 | 2006-09-22 |
| 1982702361 | Tammy Jan Jedlicka | Social Worker | 505 Bemidji Ave N Ste 2, Bemidji, MN 56601-3091 | 2006-09-20 |
| 1639188543 | Kathryn Jane Faver | Social Worker | 210 Beltrami Ave Nw, Bemidji, MN 56601-4008 | 2006-08-07 |
| 1063464824 | Booshke Mental Health Inc. | Social Worker | 522 Beltrami Ave Nw Ste 116, Bemidji, MN 56601-3002 | 2006-05-17 |
| Find all providers in BEMIDJI | ||||
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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.