Individual provider Active NPI

Mark Daniel Simpson, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1023368586
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7338 Issued in MN
Practice address
525 Portland Ave South
5TH Floor, Cope
Minneapolis, MN 55415
Phone
(612) 596-6584
NPI assigned
Sep 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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 7338 MN Primary

Addresses

Primary practice location

525 Portland Ave South
5TH Floor, Cope
Minneapolis, MN 55415

Mailing address

525 Portland Ave South
5TH Floor, Cope
Minneapolis, MN 55415
Phone (612) 348-5358

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

State licenses

LicenseStateTypeSpecialty
7338MNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1023368586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE SOUTH",
            "address_2": "5TH FLOOR, COPE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-348-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE SOUTH",
            "address_2": "5TH FLOOR, COPE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-596-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "7338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.