Active NPI
Melia Joy McCubbin, MSW, LICSW
- Clinical Social Worker
- Golden Valley, MN
National Provider Identifier
1013286780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19778
- Practice address
- 701 Decatur Ave N
Suite 109
Golden Valley, MN 55427-4367 - Phone
- (763) 746-2400
- NPI assigned
- Dec 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 19778 | MN | Primary |
Addresses
Primary practice location
701 Decatur Ave N
Suite 109
Golden Valley, MN 55427-4367
Mailing address
701 Decatur Ave N
Suite 109
Golden Valley, MN 55427-4367
Phone (763) 746-2400
Other names 1
- Melia Joy McCubbin Daniels
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2023 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324598400000",
"number": "1013286780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 DECATUR AVE N",
"address_2": "SUITE 109",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554274367",
"telephone_number": "763-746-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 DECATUR AVE N",
"address_2": "SUITE 109",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554274367",
"telephone_number": "763-746-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCUBBIN",
"first_name": "MELIA",
"middle_name": "JOY",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-23",
"last_updated": "2011-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "19778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELIA",
"last_name": "MCCUBBIN DANIELS",
"middle_name": "JOY",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.