The Midwest Trauma Center and Family Resources

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15212 Issued in MN

Legal business name

THE MIDWEST TRAUMA CENTER AND FAMILY RESOURCES

Practice address

7400 Metro Blvd Ste 413
Edina, MN 55439-2326

Phone

(218) 310-2864

NPI assigned

Oct 17, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Loralee Ann Carter, LICSW

Title

Owner

Phone

(218) 310-2864

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Midwest Trauma Center Doing business as

Locations

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1356530224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 413",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392326",
            "telephone_number": "218-310-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 413",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392326",
            "telephone_number": "218-310-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MIDWEST TRAUMA CENTER AND FAMILY RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LORALEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-310-2864",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "77B26CA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "62-64099",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "858247500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Trauma Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Edina, MN
• Providers in Edina, 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 6, 2008; 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.