Joan W. Lally, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16607 Issued in MN

Practice address

11900 Wayzata Blvd
Suite 200
Minnetonka, MN 55305-2031

Phone

(952) 270-4040

Fax

(952) 546-1308

NPI assigned

Jan 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Center for Women'S Group Therapy

  • Professional Counselor
  • Minnetonka, MN
  • NPI 1831576453
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1477531424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 WAYZATA BLVD",
            "address_2": "SUITE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052031",
            "telephone_number": "952-270-4040",
            "fax_number": "952-546-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 WAYZATA BLVD",
            "address_2": "SUITE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052031",
            "telephone_number": "952-270-4040",
            "fax_number": "952-546-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLY",
        "first_name": "JOAN",
        "middle_name": "W.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Pediatric Therapy, Inc.
• Lakeside Health Solutions
• Lakeside Health Solutions
• Hannah Lakmann
• Isabella Laleman
• Johanna Lee Lamm, PSY.D, L.P.
• Molly M Lammie, D.O.
• Darren A Lane, MA, LMFT
• Tamika Counts Lang, NP
• Emily Lange

• Clinical Social Worker in Minnetonka, MN
• Providers in Minnetonka, 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 Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.