Lacey Raye Brown

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31191 Issued in MN

Practice address

200 4TH Ave W
Shakopee, MN 55379-1220

Phone

(952) 496-8907

Fax

(952) 496-8355

NPI assigned

Jan 21, 2026

Last updated

Jan 21, 2026By the provider in NPPES

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

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, 2022

Medicare assignment

May accept Medicare assignment

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Scott

  dba Scott County Mental Health Center

  • Psychologist
  • Shakopee, MN
  • NPI 1841299443
  Medicare reassignment NPD
• County of Scott

  • Public Health or Welfare Agency
  • Shakopee, MN
  • NPI 1821156183
  NPD

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

{
    "created_epoch": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1295694529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8907",
            "fax_number": "952-496-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8907",
            "fax_number": "952-496-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LACEY",
        "middle_name": "RAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Lea Bromeland, OTR/L
• Sasha Kohana-Yamada Broniola
• Brooks Chiropractic, PLLC
• Audrey Grace Brooks I
• Jennifer Brosz, P.T.
• Megan Patricia Brownlee, MS, LPCC
• Jennifer Brummer, LICSW
• Ellie Buabeng
• Mark T Burnett, MT-BC, NMT
• Trevor L Busch, MD

• Clinical Social Worker in Shakopee, MN
• Providers in Shakopee, 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 Jan 21, 2026; 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.