Brenna Lyn Macdonald, MSW, LICSW
Individual provider Active NPI Clinical Social Worker · Pine City, MN
NPI 1346692886 · NPPES record last updated Jul 8, 2016
Key facts
- NPI
- 1346692886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 21689 (MN)
- Practice address
- 220 Railroad St SE
Pine City, MN 55063-1540 - Phone
- (320) 629-7600
- Fax
- (651) 925-0071
- NPI assigned
- Jul 8, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21689 | MN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21689 | MN | Yes |
Addresses
Primary practice location
220 Railroad St SE
Pine City, MN 55063-1540
Mailing address
220 Railroad St SE
Pine City, MN 55063-1540
Phone (320) 629-7600
Other providers in Pine City, MN
- Lakeside Medical Center, Inc.
- Deborah Diane Larson
- Lifts
- Debra Ann Lindau
- Katrina Carlene Lussier-Erickson
- Kathryn Marvin
- Josie Marie Mattheis-McGeehan
- Kari Michelle-Ferber Maynard
- Ashley McDonald
- Mary Alice Rose McHugh
All providers in Pine City, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.