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ANDRINA LEE BRANTLEY LCSWA
NPI 1104564293
Social Worker - Clinical in Grand Forks, ND

Active since May 26, 2022PECOS EnrolledAccepts Medicare Assignment
3674 S WASHINGTON ST, GRAND FORKS, ND 58201(701) 205-3000(701) 732-2501 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 26, 2026, Jan 22, 2026, May 26, 2022 (3 updates tracked since 2022).

About Andrina Lee Brantley Lcswa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDRINA LEE BRANTLEY LCSWA (NPI 1104564293) is an individual clinical provider in Grand Forks, North Dakota, licensed in North Carolina (C017280) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1104564293
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameANDRINA LEE BRANTLEYCredential: LCSWA
Location Address3674 S WASHINGTON STGrand Forks, ND 58201-5766
Mailing AddressPo Box 5210Grand Forks, ND 58206-5210 · (701) 205-3000 · Fax (701) 732-2501
Phone(701) 205-3000
Fax(701) 732-2501
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateMay 26, 2022
Last NPPES UpdateJanuary 26, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2026
✔ NPI 1104564293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NC · C017280
Definition
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.
3674 S WASHINGTON ST, Grand Forks, ND 58201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of NC and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrina Lee Brantley Lcswa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416485859
PECOS Enrollment IDI20250113001634, I20250219002302, I20250310003035, I20250325001832, I20250623002201
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Andrina Brantley reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Peterson Medical Clinics, LLC
Same address
Multi-Specialty
3674 S WASHINGTON ST
Grand Forks, ND 58201
  • Reassigned Medicare billing, Alaska, Minnesota, Montana, North Carolina, North Dakota and South Dakota enrollments
  • 70 clinicians in this Medicare group
NPI 1699295774 (701) 205-3000
Cowlitz Indian Tribe
1,217 mi
Rehabilitation, Substance Use Disorder
7105 NE 40TH ST
Vancouver, WA 98661
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Bristol Bay Area Health Corporation
  • 360 clinicians in this Medicare group
NPI 1538412630 (360) 353-9431
Norton Sound Health Corporation
2,709 mi
Critical Access
1000 GREG KRUSCHEK AVE
Nome, AK 99762
  • Reassigned Medicare billing, Alaska enrollment
  • Also billed through NPI 1225101041 (Alaska)
  • 193 clinicians in this Medicare group
NPI 1154358232 (907) 443-3311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $55.75 – $168.12
Typical copayment $0.00 (range $13.93 – $42.03)
Most-billed visit code NA
Established Patient
$69.48 typical visit price
range $18.11 – $137.65
Typical copayment $17.37 (range $4.52 – $34.41)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHERBIE DARBOUZE PA-C
Physician Assistant
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
MIRANDA EDEN DAVIS PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
MRS. REBECCA LYNNE OHLSON LCSW
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
JALISA GILES LCSW
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
GWEN LOTTA LCSW
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
ASHLEY R STOWELL
Social Worker (Clinical)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
CHERYL TREDWAY LPCC, LCPC
Counselor (Professional)
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000
KELE FERREIRA PA-C
Physician Assistant
3674 S WASHINGTON ST
GRAND FORKS, ND 58201
Grand Forks County (701) 205-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrina Brantley's NPI number?

The NPI number for Andrina Brantley is 1104564293. It was assigned to this individual provider in the NPPES registry on May 26, 2022.

Where is Andrina Brantley located?

Andrina Brantley practices at 3674 S Washington St, Grand Forks, ND 58201. The listed phone number is (701) 205-3000.

What is Andrina Brantley's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Andrina Brantley enrolled in Medicare?

Yes. Andrina Brantley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Andrina Brantley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrina Brantley reassigns Medicare benefits to 3 organizations: Peterson Medical Clinics, LLC (Grand Forks, ND), Cowlitz Indian Tribe (Vancouver, WA) and Norton Sound Health Corporation (Nome, AK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrina Brantley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrina Brantley accept?

Health plans from Avera Health Plans, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of NC and HealthPartners and 3 other insurers list Andrina Brantley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Andrina Brantley was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.