Danny Paul Porter, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12179 Issued in MN

Practice address

762 Meyer St N
Maplewood, MN 55119-3861

Phone

(612) 998-3387

NPI assigned

May 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1336714765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 MEYER ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551193861",
            "telephone_number": "612-998-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 MEYER ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551193861",
            "telephone_number": "612-998-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DANNY",
        "middle_name": "PAUL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12179",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Pickett
• Margaret Pierce, MS
• Victor Pilon, PA-C
• Ernestine Dawa Pinto Ledezma, D.D.S
• Gayla Marie Pleggenkuhle, PT
• Johnathan Scott Powell
• Laura Ann Powers, PA-C
• James L Prall, MD
• Prevail Psychiatric Services
• Professional Service Group

• Clinical Social Worker in Maplewood, MN
• Providers in Maplewood, 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 May 27, 2021; 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.