Active NPI
Maureen R McNeal, LICSW,LMFT
- Clinical Social Worker
- Wayzata, MN
National Provider Identifier
1396045175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7502
- Practice address
- 18300 Minnetonka Blvd
112
Wayzata, MN 55391-3272 - Phone
- (952) 250-8639
- Fax
- (952) 933-1046
- NPI assigned
- Oct 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7502 | MN | Primary |
| Marriage & Family Therapist | 106H00000X | 57 | MN |
Addresses
Primary practice location
18300 Minnetonka Blvd
112
Wayzata, MN 55391-3272
Mailing address
18300 Minnetonka Blvd
112
Wayzata, MN 55391-3272
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288137600000",
"number": "1396045175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18300 MINNETONKA BLVD",
"address_2": "112",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553913272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 MINNETONKA BLVD",
"address_2": "112",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553913272",
"telephone_number": "952-250-8639",
"fax_number": "952-933-1046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNEAL",
"first_name": "MAUREEN",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "LICSW,LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-27",
"last_updated": "2010-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "7502",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "57",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayzata, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.