Individual provider Active NPI

Tanya Jean Rand, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1366464422
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16617 Issued in MN
Practice address
69 Exchange St W
Saint Paul, MN 55102-1004
Phone
(651) 232-3000
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16617 MN Primary

Addresses

Primary practice location

69 Exchange St W
Saint Paul, MN 55102-1004

Mailing address

7690 Hyde Ave S
Cottage Grove, MN 55016-1977
Phone (651) 459-3697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366464422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7690 HYDE AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550161977",
            "telephone_number": "651-459-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 EXCHANGE ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021004",
            "telephone_number": "651-232-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAND",
        "first_name": "TANYA",
        "middle_name": "JEAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.