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FATAI ADESHINA POPOOLA LICSW,LADC
NPI 1174035331
Social Worker - Clinical in Minneapolis, MN

Active since October 27, 2017PECOS Enrolled
525 PORTLAND AVE # MC963, MINNEAPOLIS, MN 55415(612) 396-2280 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 6, 2025, Jan 26, 2023, Oct 27, 2017 (3 updates tracked since 2017).

About Fatai Adeshina Popoola Licsw,ladc NPPES

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

FATAI ADESHINA POPOOLA LICSW,LADC (NPI 1174035331) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (24938) and active in the NPI registry since October 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174035331
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameFATAI ADESHINA POPOOLACredential: LICSW,LADC
Location Address525 PORTLAND AVE # MC963Minneapolis, MN 55415-1533
Mailing Address525 Portland Ave # Mc963Minneapolis, MN 55415-1533 · (612) 396-2280 · Fax (612) 466-9432
Phone(612) 396-2280
Sole ProprietorYes
Enumeration DateOctober 27, 2017
Last NPPES UpdateFebruary 6, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2025
✔ NPI 1174035331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 24938
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 303521 (MN)
Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X
525 PORTLAND AVE # MC963, Minneapolis, MN 55415
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fatai Adeshina Popoola Licsw,ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

2

Medicare enrollment records show Fatai Popoola reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Amazing Health L. L. C.
4.8 mi
Psychiatric/Mental Health
625 SNELLING AVE N UNIT A-2
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Amazing Health
  • 4 clinicians in this Medicare group
NPI 1750043410 (952) 288-9921
Mental Health Specialty Group PA
975 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Minnesota enrollment
  • 98 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

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 55415 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 $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

THOMAS MCCARTHY JR.
Counselor (Mental Health)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 596-1223
MS. SARAH KAY BREYETTE MSW, LICSW
Social Worker (Clinical)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 596-1223
KHONG KALEB MUA M.A.
Marriage & Family Therapist
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 596-1223
SUAD ISMAIL LPPC
Counselor (Professional)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 596-1223
DOUG MCCARTHY BEUMER LICSW
Social Worker (Clinical)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 348-2233
MATTHEW JOHN STIEHM MA
Counselor (Professional)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 596-1223
ALISON JEAN JOHNSON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 990-4152
JORDAN TUFF LICSW
Social Worker (Clinical)
525 PORTLAND AVE # MC963
MINNEAPOLIS, MN 55415
Hennepin County (612) 596-1223

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 Fatai Popoola's NPI number?

The NPI number for Fatai Popoola is 1174035331. It was assigned to this individual provider in the NPPES registry on October 27, 2017.

Where is Fatai Popoola located?

Fatai Popoola practices at 525 Portland Ave # Mc963, Minneapolis, MN 55415. The listed phone number is (612) 396-2280.

What is Fatai Popoola's specialty?

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

Is Fatai Popoola enrolled in Medicare?

Yes. Fatai Popoola is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Fatai Popoola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Fatai Popoola reassigns Medicare benefits to 2 organizations: Amazing Health L. L. C. (Saint Paul, MN) and Mental Health Specialty Group PA (Durham, NC). 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 Fatai Popoola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Fatai Popoola accept?

Health plans from HealthPartners list Fatai Popoola 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 Fatai Popoola was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.