Individual provider Active NPI

Ana Sophia Alman McRae, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1053919605
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
26668 Issued in MN
Practice address
2920 Dean Pkwy Apt 109
Minneapolis, MN 55416-4442
Phone
(612) 200-3440
NPI assigned
Oct 15, 2020
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 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 26668 MN Primary

Addresses

Primary practice location

2920 Dean Pkwy Apt 109
Minneapolis, MN 55416-4442

Mailing address

2920 Dean Pkwy Apt 109
Minneapolis, MN 55416-4442
Phone (612) 200-3440

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 18, 2024 through Jan 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26668MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1053919605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 DEAN PKWY APT 109",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164442",
            "telephone_number": "612-200-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 DEAN PKWY APT 109",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164442",
            "telephone_number": "612-200-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMAN MCRAE",
        "first_name": "ANA",
        "middle_name": "SOPHIA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2024-02-21",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.