Melissa Macklin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22679 Issued in MN

Practice address

2030 Rahn Way
Eagan, MN 55122-2300

Phone

(651) 529-1971

Fax

(612) 728-5301

NPI assigned

May 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa McCanney Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  Medicare reassignment NPD
• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1538514906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 RAHN WAY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222300",
            "telephone_number": "651-529-1971",
            "fax_number": "612-728-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 RAHN WAY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222300",
            "telephone_number": "651-529-1971",
            "fax_number": "612-728-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "MELISSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MCCANNEY",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew D Maas, MD
• Rayan Ali Macalin
• Lynda Macaulay
• Clare Louise Macdonald-Sexton, LICSW
• Bradley Dean Mack, LATC
• Madina Wellness Center, Inc.
• Amal Mahamed
• Mohamed Hussein Mahamed
• Nastesho Mahamed
• Sirad Abdi Mahamed

• Clinical Social Worker in Eagan, MN
• Providers in Eagan, 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 Nov 20, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.