Individual provider Active NPI

Madalyn Lazur Cioci, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1497321772
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30031 Issued in MN
Practice address
4027 County Road 25
Minneapolis, MN 55416-2629
Phone
(612) 925-6033
Fax
(612) 925-8496
NPI assigned
May 27, 2021
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 30031 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

4027 County Road 25
Minneapolis, MN 55416-2629

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

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
I20240318000244 MN Practitioner - Clinical Social Worker 8426495110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians

Practice addresses (Care Compare)

4027 County Rd
Suite 25
St Louis Park, MN 55416-4119
Phone (612) 925-6033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30031MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinic of Psychology Inc CurrentSince Jan 22, 2024 Accepting new patients

Locations

4027 County Road 25
St Louis Park, MN 55416
Phone (612) 925-6033

4240 Park Glen Rd
St Louis Park, MN 55416
Phone (612) 925-6033

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1497321772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 COUNTY ROAD 25",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162629",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIOCI",
        "first_name": "MADALYN",
        "middle_name": "LAZUR",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30031",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.