Individual provider Active NPI

Danielle Banal, MSW, LICSW

  • Clinical Social Worker
  • St Louis Park, MN
National Provider Identifier
1356178198
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31172 Issued in MN
Practice address
3340 Republic Ave Ste 110
St Louis Park, MN 55426-4156
Phone
(952) 209-1510
Fax
(952) 209-1511
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 31172 MN Primary

Addresses

Primary practice location

3340 Republic Ave Ste 110
St Louis Park, MN 55426-4156

Mailing address

3340 Republic Ave Ste 110
St Louis Park, MN 55426-4156
Phone (952) 209-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 26, 2024 through Sep 26, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novo Behavioral Health, LLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

3340 Republic Ave
Ste 110
St Louis Park, MN 55426
Phone (952) 209-1510

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1356178198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 110",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264156",
            "telephone_number": "952-209-1510",
            "fax_number": "952-209-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 110",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264156",
            "telephone_number": "952-209-1510",
            "fax_number": "952-209-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAL",
        "first_name": "DANIELLE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.