JESSICA FANBERG (NPI# 1679947543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679947543 |
| Entity Type | Individual |
| Full Name | JESSICA FANBERG |
| Other Name | JESSICA GINGERY |
| Practice Address |
3833 Coon Rapids Blvd Nw Ste 120 Coon Rapids MN 55433-2599 |
| Practice Telephone | 7637673350 |
| Practice Fax Number | 7637470912 |
| Mailing Telephone | 7637673350 |
| Mailing Fax Number | 7637470912 |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
18522 | MN | Behavioral Health & Social Service Providers |
| Street Address |
3833 COON RAPIDS BLVD NW STE 120 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821057910 | Amy M Berglin | Allergy & Immunology | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2006-03-20 |
| 1891250163 | Patricia Sandkamp | Marriage & Family Therapist | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2019-01-31 |
| 1972075893 | Shu-chun Lee | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2018-12-18 |
| 1083108138 | Kristal Ficzeri | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2018-06-20 |
| 1164961413 | Richard Todd | Psychologist | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2017-02-20 |
| 1912456062 | Tara Tait | Physician Assistant | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2016-09-30 |
| 1043670581 | Abigail Fletcher | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2016-02-25 |
| 1215319504 | Valissa Milanovich | Marriage & Family Therapist | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2015-06-23 |
| 1891199378 | Christina Staebell | Social Worker | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2014-10-13 |
| 1487058020 | Melissa Langewisch | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2014-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1871757054 | Gretchen Marie Nelson | Social Worker | 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2008-07-16 |
| 1073788386 | Joseph John Wittenberg | Social Worker | 11220 Crocus St Nw, Coon Rapids, MN 55433 | 2008-04-28 |
| 1922298140 | Emily Wells | Social Worker | 2320 130th Ave Nw, Coon Rapids, MN 55448-2543 | 2007-07-25 |
| 1568436525 | Ladonna Rae Meinecke | Social Worker | 11475 Robinson Dr Nw, Mail Stop 32600a, Coon Rapids, MN 55433-3746 | 2006-02-15 |
| 1760489751 | Family Life Mental Health Center | Social Worker | 1930 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4708 | 2005-07-05 |
| 1396350948 | Elizabeth Ashley Mann | Social Worker | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-09-10 |
| 1588290183 | Alison Elizabeth Potter | Social Worker | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-03-16 |
| 1033758438 | Jennifer Andrews | Social Worker | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-01-02 |
| 1578100913 | Kaitlin Marie Barrett | Social Worker | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2019-12-04 |
| 1376186320 | Ami Nichole Cantway | Social Worker | 199 Coon Rapids Blvd Nw Ste 306, Coon Rapids, MN 55433-5861 | 2019-10-22 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.