Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Blaine Robert Boverhuis, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1275210338

Mr. Blaine Robert Boverhuis, MSW, LICSW is a Clinical Social Worker in Edina, Minnesota. Qualified in 2020, 6 years ago. Practices with Fairview Express Care, a 1,964-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2023
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

6401 France Ave S
Edina, MN 55435-2104
Phone: (952) 924-2888
Fax: (952) 924-2880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 19085 (MN)

Record details

NPI number1275210338
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , LICSW
Sole proprietorYes
NPI enumeratedJune 30, 2023
Last updated in NPPESJune 30, 2023
Certification dateJune 30, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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