Individual provider Active NPI

Mary Stevenson Dunnavan, MSW

  • Social Worker
  • Edina, MN
National Provider Identifier
1144298365
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
01731 Issued in MN
Practice address
7200 France Avenue South
Suite 234
Edina, MN 55435
Phone
(952) 831-0601
Fax
(952) 831-0614
NPI assigned
Mar 14, 2006
Last updated
Aug 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 01731 MN Primary
Clinical Social Worker 1041C0700X 1731 MN
Marriage & Family Therapist 106H00000X 584 MN
Marriage & Family Therapist 106H00000X 0584 MN

Addresses

Primary practice location

7200 France Avenue South
Suite 234
Edina, MN 55435

Mailing address

7200 France Avenue South
Suite 234
Edina, MN 55435
Phone (952) 831-0601

Other identifiers 1

IdentifierTypeStateIssuer
827757500MedicaidMN

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
01731MNMDSocial Worker
0584MNMDMarriage & Family Therapist
1731MNMDAthletic Trainer
584MNMDNeonatal Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1144298365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 FRANCE AVENUE SOUTH",
            "address_2": "SUITE 234",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-831-0601",
            "fax_number": "952-831-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 FRANCE AVENUE SOUTH",
            "address_2": "SUITE 234",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-831-0601",
            "fax_number": "952-831-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNAVAN",
        "first_name": "MARY",
        "middle_name": "STEVENSON",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "01731",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "1731",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "584",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "0584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "827757500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.