Susan M Dolph, LICSW in Duluth, MN - Medicare Social Worker Provider

Susan M Dolph, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Duluth, Minnesota. Her current practice location is 5723 Grand Ave Ste 2, Duluth, Minnesota. You can reach out to her office (for appointments etc.) via phone at (218) 461-6468.

Susan M Dolph is licensed to practice in Minnesota (license number 13359) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063065019.

Contact Information

	Susan M Dolph, LICSW
	5723 Grand Ave Ste 2, Duluth, MN 55807-2567
	(218) 461-6468
	(218) 212-9933

Map and Direction

Healthcare Provider's Profile

Full Name	Susan M Dolph
Gender	Female
Speciality	Social Worker - Clinical
Location	5723 Grand Ave Ste 2, Duluth, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063065019
Provider Enumeration Date: 07/18/2019
Last Update Date: 01/09/2025

Medicare PECOS Information:

PECOS PAC ID: 9537678545
Enrollment ID: I20250602002079

Medical Identifiers

Medical identifiers for Susan M Dolph such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063065019	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	9614-123 (Wisconsin)	Secondary
1041S0200X	Social Worker - School	13359 (Minnesota)	Secondary
1041C0700X	Social Worker - Clinical	13359 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Susan M Dolph allows following entities to bill medicare on her behalf.

Entity Name	Tapestry Psychotherapy Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184216657 PECOS PAC ID: 8628587631 Enrollment ID: O20250602001950

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan M Dolph is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Susan M Dolph, LICSW 5723 Grand Ave Ste 2, Duluth, MN 55807-2567 Ph: (218) 461-6468	Susan M Dolph, LICSW 5723 Grand Ave Ste 2, Duluth, MN 55807-2567 Ph: (218) 461-6468

Reviews and Comments

Social Worker in Duluth, MN

Melissa Ann Winkler, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4000 W 9th St, Duluth, MN 55807 Phone: 218-625-2638 Fax: 651-323-2184
Emily Lundgren, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11 E Superior St Ste 415, Duluth, MN 55802 Phone: 218-249-0595
Megan Elizabeth Tezak, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 810 E 4th St, Duluth, MN 55805 Phone: 218-728-4491 Fax: 218-302-8698
Glenn Howard Tobey, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 17 1/2 N Lake Ave Rm 201, Duluth, MN 55802 Phone: 218-740-4389 Fax: 218-740-4389
Emma Faye Shannon, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1502 London Rd Ste 205, Duluth, MN 55812 Phone: 612-234-4689 Fax: 612-234-4689
Natalie Jo Ryan, MSW, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 810 E 4th St, Duluth, MN 55805 Phone: 218-624-5683 Fax: 218-624-5736
Zayla Asquith-heinz, LGSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4325 Grand Ave, Duluth, MN 55807 Phone: 218-722-1497 Fax: 218-722-6239

Susan M Dolph, LICSW - Medicare Clinical Social Worker in Duluth, MN