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EDIFY YOUTH
NPI 1477895985
Social Worker - Clinical in Crystal, MN

Active since March 22, 2013
5108 LAKESIDE AVE N, CRYSTAL, MN 55429(612) 306-4575(763) 271-2707 Get Directions Write a Review

NPPES record last updated: March 22, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edify Youth NPPES

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

EDIFY YOUTH (NPI 1477895985) is a healthcare organization registered as a clinical in Crystal, Minnesota and active in the NPI registry since March 2013. The organization lists Michele Bauer, Administrator, as its authorized official.

NPPES Registry Identity

NPI1477895985
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameEDIFY YOUTH
Location Address5108 LAKESIDE AVE NCrystal, MN 55429-3734
Mailing Address5108 Lakeside Ave NCrystal, MN 55429-3734 · (612) 306-4575 · Fax (763) 271-2707
Phone(612) 306-4575
Fax(763) 271-2707
Organization SubpartNo
Authorized OfficialMichele BauerAdministrator · (763) 567-3136
Enumeration DateMarch 22, 2013
✔ NPI 1477895985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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.
5108 LAKESIDE AVE N, Crystal, MN 55429
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

SETH ELLIOT TUPPER LICSW
Social Worker (Clinical)
5108 LAKESIDE AVE N
CRYSTAL, MN 55429
Hennepin County (651) 503-5780

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 Edify Youth's NPI number?

The NPI number for Edify Youth is 1477895985. It was assigned to this organization in the NPPES registry on March 22, 2013.

Where is Edify Youth located?

Edify Youth is located at 5108 Lakeside Ave N, Crystal, MN 55429. The listed phone number is (612) 306-4575.

What is Edify Youth's specialty?

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

When was this NPI record last updated?

The NPPES record for Edify Youth was last updated on March 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.