Individual provider Active NPI

Mary Kay Schoen, LICSW

  • Clinical Social Worker
  • New Hope, MN
National Provider Identifier
1003414376
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13969 Issued in MN
Practice address
6100 W Broadway Ave Apt 102
New Hope, MN 55428-2887
Phone
(763) 222-6042
NPI assigned
Oct 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13969 MN Primary

Addresses

Primary practice location

6100 W Broadway Ave Apt 102
New Hope, MN 55428-2887

Mailing address

6100 W Broadway Ave Apt 102
New Hope, MN 55428-2887
Phone (763) 222-6042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1003414376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 W BROADWAY AVE APT 102",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554282887",
            "telephone_number": "763-222-6042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 W BROADWAY AVE APT 102",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554282887",
            "telephone_number": "763-222-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOEN",
        "first_name": "MARY",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2024-11-18",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hope, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.