MEGAN HICKENBOTTOM (NPI# 1093277238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093277238 |
| Entity Type | Individual |
| Full Name | MEGAN HICKENBOTTOM |
| Credential | LICSW |
| Practice Address |
2855 Campus Dr Plymouth MN 55441-2649 |
| Mailing Address |
3305 Queensland Ln N Plymouth MN 55447-1133 |
| Practice Telephone | 7635777000 |
| Mailing Telephone | 6127205632 |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
22369 | MN | Behavioral Health & Social Service Providers |
| Street Address |
2855 CAMPUS DR |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-2649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639171820 | Terry W. Hood | Neurological Surgery | 2855 Campus Dr, Ste 570, Plymouth, MN 55441-2660 | 2005-06-01 |
| 1891309092 | Bridget Pauline Williams | Pharmacist | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2020-09-04 |
| 1831670470 | Stephanie Michelle Walek | Pharmacist | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2018-08-22 |
| 1821502154 | Michael Blake Jacob | Orthopaedic Surgery | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2017-11-22 |
| 1457741092 | Narges Golgol | Physician Assistant | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2015-02-04 |
| 1295131357 | Eva Gabriela Martinez | Physical Therapist | 2855 Campus Dr, Suite 650, Plymouth, MN 55441-2649 | 2014-11-17 |
| 1336495068 | Allina Health System | Clinic/Center | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2012-07-31 |
| 1477828515 | Vedavathi Ramesh Bellamkonda-athmaram | Pediatrics | 2855 Campus Dr, #350, Plymouth, MN 55441-2649 | 2012-03-21 |
| 1568739043 | Allina Health System | Clinic/Center | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2011-11-28 |
| 1831466317 | Allina Health System | Clinic/Center | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2011-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| 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 |
|---|---|---|---|---|
| 1639778996 | Angela Gaynor | Social Worker | 68 Nautical Way, Plymouth, MA 02360-8611 | 2020-10-19 |
| 1649888637 | Look Within Counseling LLC | Social Worker | 1098 Ann Arbor Rd W # 588, Plymouth, MI 48170-2129 | 2020-07-16 |
| 1982236808 | Resilience Coach, LLC | Social Worker | 705 S Main St Ste 101b, Plymouth, MI 48170-1060 | 2020-02-08 |
| 1275178436 | Jennifer A Abraham | Social Worker | 135 Rocky Hill Rd, Plymouth, MA 02360-5524 | 2019-11-12 |
| 1073164349 | Alishia Ebel Lmsw LLC | Social Worker | 496 W Ann Arbor Trl Ste 106, Plymouth, MI 48170-6262 | 2019-09-26 |
| 1366926206 | Elizabeth Paronich | Social Worker | 9 Hibiscus Ln, Plymouth, MA 02360-5344 | 2018-09-17 |
| 1992288609 | Robert Eisenstein | Social Worker | 15 Gallagher Dr, Plymouth, MA 02360-1407 | 2018-09-09 |
| 1306329271 | Patricia Jane Whitaker | Social Worker | Masac-plymouth, 1 Bumps Pond Road, Plymouth, MA 02360 | 2018-09-07 |
| 1588146914 | Alicia Mae Donahue | Social Worker | 15805 26th Ave N Unit D, Plymouth, MN 55447 | 2018-09-01 |
| 1003398645 | Judith A Gonsalves | Social Worker | 36 Cordage Park Cir Ste 326, Plymouth, MA 02360-7320 | 2018-08-30 |
| Find all providers in PLYMOUTH | ||||
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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.