Individual provider Active NPI

Valerie Penner, DSW,MSW

  • Clinical Social Worker
  • Burnsville, MN
National Provider Identifier
1639431695
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20802 Issued in MN
Practice address
2530 Horizon Dr
Burnsville, MN 55337-3091
Phone
(651) 209-8640
Fax
(651) 209-8690
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20802 MN Primary

Addresses

Primary practice location

2530 Horizon Dr
Burnsville, MN 55337-3091

Mailing address

2530 Horizon Dr
Burnsville, MN 55337-3091
Phone (651) 209-8640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1639431695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 HORIZON DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373091",
            "telephone_number": "651-209-8640",
            "fax_number": "651-209-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 HORIZON DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553373091",
            "telephone_number": "651-209-8640",
            "fax_number": "651-209-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "VALERIE",
        "name_prefix": "Dr.",
        "credential": "DSW,MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.