MEDICARE: GEOFFREY THOMAS ABBOTT LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	3977	MN
2	1041C0700X	Clinical Social Worker	3977	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100593	OTHER	MN	UCARE
2	62-55425	OTHER	MN	MEDICA CHOICE AND PRIMARY
3	1019266	OTHER	MN	PREFERRED ONE
4	37B39AB	OTHER	MN	BCBS
5	767983	OTHER	MN	ARAZID
6	HP27477	OTHER	MN	HEALTHPARTNERS

General Provider Information

NPI Number	:	1952345639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEOFFREY THOMAS ABBOTT LICSW

Provider Business Mailing Address
First Line	:	1020 W BROADWAY AVE
Second Line	:	UMPHYSICIANS BROADWAY FAMILY MEDICINE
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2504
Country	:	US
Telephone Number	:	612-302-8200
Fax Number	:	612-302-8275

Provider Business Practice Location Address
First Line	:	1020 W BROADWAY AVE
Second Line	:	UMPHYSICIANS BROADWAY FAMILY MEDICINE
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-2504
Country	:	US
Telephone Number	:	612-302-8200
Fax Number	:	612-302-8275

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	09/11/2025

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