Individual provider Active NPI

Marsha Zuckerman, MSSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1124371745
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1000 Issued in MN
Practice address
3915 Golden Valley Road
Courage Center
Minneapolis, MN 55422-4298
Phone
(763) 520-0721
Fax
(763) 520-0869
NPI assigned
Oct 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 1000 MN Primary

Addresses

Primary practice location

3915 Golden Valley Road
Courage Center
Minneapolis, MN 55422-4298

Mailing address

3915 Golden Valley Road
Courage Center
Minneapolis, MN 55422
Phone (763) 520-0721

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1000MNMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1124371745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY ROAD",
            "address_2": "COURAGE CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-520-0721",
            "fax_number": "763-520-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY ROAD",
            "address_2": "COURAGE CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224298",
            "telephone_number": "763-520-0721",
            "fax_number": "763-520-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKERMAN",
        "first_name": "MARSHA",
        "credential": "MSSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "1000",
            "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 Oct 19, 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.