Molly Young Sheppard, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21150 Issued in MN

Practice address

2550 University Ave W Ste 216S
Saint Paul, MN 55114-1916

Phone

(952) 993-6200

Fax

(952) 977-1802

NPI assigned

Sep 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Molly Sheppard Burk Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD
• Greater Minneapolis Crisis Nursery

  • Community/Behavioral Health Agency
  • Golden Valley, MN
  • NPI 1427308360
  NPD (past)
• Washburn Center for Children

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1225136419
  NPD (past)

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1184092942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W STE 216S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141916",
            "telephone_number": "952-993-6200",
            "fax_number": "952-977-1802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4544 4th Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554195145",
            "country_code": "US",
            "telephone_number": "763-591-0100",
            "fax_number": "763-271-2707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Glenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554051430",
            "country_code": "US",
            "telephone_number": "612-871-1454",
            "fax_number": "612-871-1505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "MOLLY",
        "middle_name": "YOUNG",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "BURK",
            "middle_name": "SHEPPARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Sheka, M.D.
• Shelley S. Berven and Associates, LLC
• Jonathan David Shelver, M.D.
• Katherine Marie Shephard, PT, DPT
• Megan Shepherd, PT
• Sherburne Recovery Services LLC
• Kevin J Sheridan, MD
• Gayle Sherman Crandell, M.A.
• Cindy Sherman
• Cynthia A Sherman, MD

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.