Michelle Renee Nyman McKinley, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18791 Issued in MN

Practice address

38698 Highway 109
Winnebago, MN 56098-4640

Phone

(507) 405-7305

NPI assigned

Jan 30, 2022

Last updated

Jan 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1386397461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38698 HIGHWAY 109",
            "city": "WINNEBAGO",
            "state": "MN",
            "postal_code": "560984640",
            "telephone_number": "507-405-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38698 HIGHWAY 109",
            "city": "WINNEBAGO",
            "state": "MN",
            "postal_code": "560984640",
            "telephone_number": "507-405-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYMAN MCKINLEY",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "18791",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Winnebago, MN
• Providers in Winnebago, 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 Jan 30, 2022; 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.