Dana M Mostoller

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20849 Issued in MN

Practice address

659 Bielenberg Dr Ste 100
Woodbury, MN 55125-1707

Phone

(612) 274-7419

Fax

(651) 259-9780

NPI assigned

Aug 18, 2009

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

Other identifiers 1

Other names 1

• Ms. Dana M Mostoller Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1407088958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 BIELENBERG DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251707",
            "telephone_number": "612-274-7419",
            "fax_number": "651-259-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 BIELENBERG DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251707",
            "telephone_number": "612-274-7419",
            "fax_number": "651-259-9780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6230 10th St N",
            "address_2": "Ste#210",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "MN",
            "postal_code": "551286158",
            "country_code": "US",
            "telephone_number": "651-368-5080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTOLLER",
        "first_name": "DANA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20849",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508814625",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "MOSTOLLER",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, 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 Apr 20, 2018; 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.