Brendan Shane

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13192 Issued in MN

Legal business name

BRENDAN SHANE

Practice address

7575 Golden Valley Rd
Suite 370
Golden Valley, MN 55427-4562

Phone

(952) 334-9390

NPI assigned

Dec 8, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Brendan C Shane, LICSWNPI 1720326440

Title

Owner

Phone

(952) 334-9390

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brendan C Shane, MSW, LICSW

  • Clinical Social Worker
  • Golden Valley, MN
  • NPI 1720326440
  NPD (past) Authorized official

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1366840324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6513 CREEK DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391207",
            "telephone_number": "952-334-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 GOLDEN VALLEY RD",
            "address_2": "SUITE 370",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274562",
            "telephone_number": "952-334-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDAN SHANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "SHANE",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-334-9390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Boylan, MA LMFT
• Carmen Bradbury
• Michael James Bradbury, PT
• Mollie Mary Rose Brady, LPCC
• Justin E Brank, PTA
• Herbert Allen Brenden, EDD LP
• Lance Briard
• Bright Path Home Care Solutions LLC
• George Brisse
• Mary Helen Brixius, LICSW

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, 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 Dec 8, 2014; 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.