Individual provider Active NPI

Danelle Williams, MSW LICSW

  • Clinical Social Worker
  • Shakopee, MN
National Provider Identifier
1386642114
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9603 Issued in MN
Practice address
200 4TH Ave W
Government Center, RM 300
Shakopee, MN 55379-1220
Phone
(952) 496-8569
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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 9603 MN Primary

Addresses

Primary practice location

200 4TH Ave W
Government Center, RM 300
Shakopee, MN 55379-1220

Mailing address

200 4TH Ave W
Government Center, RM 300
Shakopee, MN 55379-1220

Other names 1

  • Danelle Williams Nelson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150819009324 MN Practitioner - Clinical Social Worker 1658686621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of ScottGroup PAC ID 4587605225, 11 clinicians

Practice addresses (Care Compare)

200 4TH Ave W
Shakopee, MN 55379-1220
Phone (952) 496-8481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9603MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
County of Scott CurrentSince Apr 6, 2015 Accepting new patients
County of Scott CurrentSince Apr 6, 2015 Accepting new patients
County of Scott Past Accepting new patients

Locations

200 4th Ave W
Shakopee, MN 55379
Phone (952) 496-8481

200 4th Ave W
#300
Shakopee, MN 55379
Phone (952) 445-7751

200 4th Ave W
Rm 300
Shakopee, MN 55379
Phone (952) 496-8481

Organizations & group practices 3

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1386642114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "address_2": "GOVERNMENT CENTER, RM 300",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "address_2": "GOVERNMENT CENTER, RM 300",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DANELLE",
        "name_prefix": "Ms.",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANELLE",
            "last_name": "WILLIAMS NELSON",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Shakopee, MN

Sources for this page

Verify at the official NPI Registry.