Susan Marie Banal, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9380 Issued in MN

Practice address

5821 Cedar Lake Rd S
St Louis Park, MN 55416-1487

Phone

(651) 647-1900

Fax

(651) 647-1861

NPI assigned

Apr 6, 2007

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 identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Midwest Center for Personal and Family Development, P.a.Group PAC ID 3173436185, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Midwest Center for Personal & Family Development PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1285730903
  Medicare reassignment Care Compare group
• Pathway Virtu-Health

  • Family Nurse Practitioner
  • Shoreview, MN
  • NPI 1073134284
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1629190814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 TIMBER WOODS LN",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 CEDAR LAKE RD S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161487",
            "telephone_number": "651-647-1900",
            "fax_number": "651-647-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAL",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629190814",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristina Baker, MD
• Vicki Lee Baker
• Karl J Bakken, OD
• Analisa Ballinger
• Danielle Banal, MSW, LICSW
• Matthew Banfield, MD
• Bilikisu Banjoko, MA, LMFT
• Olufemi O Banjoko, MD
• Georgia Banks
• Jean Michelle Bannick, MOTR/L

• Clinical Social Worker in St Louis Park, MN
• Providers in St Louis Park, 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 Apr 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.