Active NPI
Megan Shane, LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1598206161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13203
- Practice address
- 6513 Creek Dr
Minneapolis, MN 55439-1207 - Phone
- (612) 418-0299
- NPI assigned
- Mar 16, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 13203 | MN | Primary |
Addresses
Primary practice location
6513 Creek Dr
Minneapolis, MN 55439-1207
Mailing address
6513 Creek Drive
Edina, MN 55439
Phone (612) 418-0299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 20, 2021 through Dec 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1598206161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6513 CREEK DRIVE",
"city": "EDINA",
"state": "MN",
"postal_code": "55439",
"telephone_number": "612-418-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6513 CREEK DR",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554391207",
"telephone_number": "612-418-0299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANE",
"first_name": "MEGAN",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-16",
"last_updated": "2020-09-14",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "13203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.