Individual provider Active NPI

Shannon Marie Murphy, MSW, LICSW, LCSW

  • Clinical Social Worker
  • St Louis Park, MN
National Provider Identifier
1609538909
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34352 Issued in MN
Practice address
1155 Ford Rd Ste B
St Louis Park, MN 55426-1115
Phone
(952) 378-1800
Fax
(952) 378-1714
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 SW19043 FL
Clinical Social Worker 1041C0700X 34352 MN Primary

Addresses

Primary practice location

1155 Ford Rd Ste B
St Louis Park, MN 55426-1115

Mailing address

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

Other practice location 1

3017 Garfield Ave Apt 2
Minneapolis, MN 55408-2924
Phone (352) 262-6263 ext. 26263

Other practice location 2

4027 County Road 25
Minneapolis, MN 55416-2629
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
I20251022001734 MN Practitioner - Clinical Social Worker 9830687862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3017 Garfield Ave
Apt 2
Minneapolis, MN 55408-2924

3017 Garfield Ave Apt
Suite 2
Minneapolis, MN 55408-2924

621 W Lake St
Suite 350
Minneapolis, MN 55408-2952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW19043FLMDClinical Social Worker
34352MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lyn-Lake Psychotherapy and Wellness LTD. CurrentSince Aug 11, 2025 Accepting new patients
Associated Clinic of Psychology Inc PastSince Sep 1, 2015 Accepting new patients
Medicine Lake Consultation Group,PLLC PastSince Jun 1, 2012 Accepting new patients

Locations

621 W Lake St
Ste 350
Minneapolis, MN 55408
Phone (612) 547-9990

2900 Thomas Ave S
Ste 100
Minneapolis, MN 55416

Interoperability endpoints

  • Direct secure messaging: shannon.murphy@489656322949124.direct.elationemr.com

Organizations & group practices 3

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1609538909",
    "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": "1155 FORD RD STE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261115",
            "telephone_number": "952-378-1800",
            "fax_number": "952-378-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3017 Garfield Ave Apt 2",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554082924",
            "country_code": "US",
            "telephone_number": "352-262-6263 x26263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4027 County Road 25",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554162629",
            "country_code": "US",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19043",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "34352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.