Theresa Stepan Land, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12605 Issued in MN

Practice address

1405 Lilac Dr N
Golden Valley, MN 55422-4535

Phone

(763) 525-9919

Fax

(763) 486-4439

NPI assigned

Jul 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1164735775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 FOREST RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454328",
            "telephone_number": "952-949-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224535",
            "telephone_number": "763-525-9919",
            "fax_number": "763-486-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "THERESA",
        "middle_name": "STEPAN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole L Lainhart, MS CCC SLP
• Justin Lajoie, LPCC
• Jutone Lajoie, LICSW
• Lacey Darlene Lake Foreman, CRNP
• Lakeview Transportation
• Rebecca Ann Lange, MA, OTR/L
• Laura E Langemak, PHARMD
• Language Link Interpreting
• John M Larotonda III, ATC
• Lisa Laurent, PTA

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.