Dawn Draayer-Thibodeau, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15185 Issued in MN

Legal business name

DAWN DRAAYER-THIBODEAU, LLC

Practice address

4500 Park Glen Rd
Suite 155
St Louis Park, MN 55416-4871

Phone

(952) 334-1213

Fax

(952) 928-9774

NPI assigned

Apr 2, 2015

Organization subpart

No

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

Authorized official

Name

Dawn Diana Draayer-Thibodeau, MSW, LICSWNPI 1972672087

Title

Therapist

Phone

(952) 334-1213

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dawn Diana Draayer-Thibodeau, LICSW

  • Clinical Social Worker
  • St Louis Park, MN
  • NPI 1972672087
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1235524521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD",
            "address_2": "SUITE 155",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164871",
            "telephone_number": "952-334-1213",
            "fax_number": "952-928-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD",
            "address_2": "SUITE 155",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164871",
            "telephone_number": "952-334-1213",
            "fax_number": "952-928-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN DRAAYER-THIBODEAU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "DRAAYER-THIBODEAU",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "DIANA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "952-334-1213",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78612312-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Davis, PA-C
• Philip D Davis, M.D.
• Sashanavian Uniqua Davis
• Susan Marie Davis, LICSW
• Thomas J Davis
• Danielle Day, DO
• Jennifer Day, M.D.
• Burhan Adam Daynab, ASSISTED LIVING
• DCB Therapies LLC
• Anthony De Angelis

• Clinical Social Worker in St Louis Park, MN
• Providers in St Louis Park, 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 Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.