Individual provider Active NPI

Marah Rae Walker, MSW, LICSW

  • Clinical Social Worker
  • Buffalo, MN
National Provider Identifier
1487429411
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30106 Issued in MN
Practice address
308 12TH Ave S
Buffalo, MN 55313-2321
Phone
(763) 682-4400
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 30106 MN Primary

Addresses

Primary practice location

308 12TH Ave S
Buffalo, MN 55313-2321

Mailing address

308 12TH Ave S
Buffalo, MN 55313-2321
Phone (763) 682-4400

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
I20240304003320 MN Practitioner - Clinical Social Worker 9830534502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30106MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Minnesota Mental Health Center CurrentSince Jan 1, 2024 Accepting new patients
Central Minnesota Mental Health Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

308 12th Ave S
Buffalo, MN 55313
Phone (763) 682-4400

407 Washington St
Monticello, MN 55362
Phone (763) 295-4001

411 3rd St N
Waite Park, MN 56387
Phone (320) 202-2037

Organizations & group practices 2

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1487429411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 12TH AVE S",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132321",
            "telephone_number": "763-682-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 12TH AVE S",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132321",
            "telephone_number": "763-682-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARAH",
        "middle_name": "RAE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

Verify at the official NPI Registry.