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DONNA ANDERSON LICSW, PA
NPI 1720351158
Social Worker - Clinical in Roseville, MN

Active since February 15, 2012
1711 COUNTY ROAD B W, SUITE 210S, ROSEVILLE, MN 55113(651) 621-2495(651) 621-2496 Get Directions Write a Review

NPPES record last updated: February 15, 2012. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Donna Anderson Licsw, Pa NPPES

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

DONNA ANDERSON LICSW, PA (NPI 1720351158) is a healthcare organization registered as a clinical in Roseville, Minnesota and active in the NPI registry since February 2012. The organization lists Donna Anderson, Psychotherapist, as its authorized official.

NPPES Registry Identity

NPI1720351158
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameDONNA ANDERSON LICSW, PA
Location Address1711 COUNTY ROAD B W, SUITE 210SRoseville, MN 55113-4057
Mailing Address1711 County Road B W, Suite 210sRoseville, MN 55113-4057 · (651) 621-2495 · Fax (651) 621-2496
Phone(651) 621-2495
Fax(651) 621-2496
Organization SubpartNo
Authorized OfficialDonna AndersonPsychotherapist · (651) 621-2495
Enumeration DateFebruary 15, 2012
✔ NPI 1720351158 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 MN · LICSW 1288
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.
1711 COUNTY ROAD B W, Roseville, MN 55113
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Donna Anderson Licsw, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Donna Anderson Licsw, PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Donna Anderson, LICSW
Clinical Social Worker
NPI 1669491908
1711 COUNTY ROAD B W ROSEWOOD OFFICE PLAZA SUITE 210S
Roseville, MN 55113
(651) 621-2495
✔ PECOS✔ Accepts MedicareSame address

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

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 Donna Anderson Licsw, PA's NPI number?

The NPI number for Donna Anderson Licsw, PA is 1720351158. It was assigned to this organization in the NPPES registry on February 15, 2012.

Where is Donna Anderson Licsw, PA located?

Donna Anderson Licsw, PA is located at 1711 County Road B W Suite 210S, Roseville, MN 55113. The listed phone number is (651) 621-2495.

What is Donna Anderson Licsw, PA's specialty?

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

Is Donna Anderson Licsw, PA enrolled in Medicare?

Yes. Donna Anderson Licsw, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Donna Anderson Licsw, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Donna Anderson Licsw, PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Donna Anderson Licsw, PA was last updated on February 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.